Information Collection

Impact Evaluation of Departmentalized Instruction in Elementary Schools

IC 229630 under ICR 201801-1850-001 · OMB 1850-0942.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1850-0942 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Impact Evaluation of Departmentalized Instruction in Elementary Schools	Form
Appendix G District_Recruitment_Letter.pdf	Other-District Recruitment Letter
Monitoring Forms and Principal Interview Protocol Appendix A Monitoring_Forms_Principal_Interview.pdf	Form
Teacher Survey with Initiave Letter Appendix B Teacher_Letter_Survey_Followup Matls.pdf	Form
Admin Records Data Request Appendix C Admin_Records_Data_Requests.pdf	Form
Class Schedule and Roster Request Letter Appendix D Letter_Requesting_Class_Schedules_and_Student_Rosters.pdf	Form
Active and Passive Parent Permission Form Appendix E Active_and_Passive_Parent_Permission.pdf	Form
School Agreement Form Appendix F School_Agreement_Form.pdf	Form

IC Title:

Impact Evaluation of Departmentalized Instruction in Elementary Schools

Agency IC Tracking Number:

ED-2018-ICCD-0001

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	N/A	Monitoring Forms and Principal Interview Protocol	Appendix A Monitoring_Forms_Principal_Interview.pdf	No	Paper Only
Form	N/A	Teacher Survey with Initiave Letter	Appendix B Teacher_Letter_Survey_Followup Matls.pdf	No	Paper Only
Form	N/A	Admin Records Data Request	Appendix C Admin_Records_Data_Requests.pdf	No	Paper Only
Form	N/A	Class Schedule and Roster Request Letter	Appendix D Letter_Requesting_Class_Schedules_and_Student_Rosters.pdf	No	Paper Only
Form	N/A	Active and Passive Parent Permission Form	Appendix E Active_and_Passive_Parent_Permission.pdf	No	Paper Only
Form	N/A	School Agreement Form	Appendix F School_Agreement_Form.pdf	No	Paper Only
Other-District Recruitment Letter			Appendix G District_Recruitment_Letter.pdf	No	Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,531

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 17 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,531	8,531
Annual IC Time Burden (Hours)	3,202	3,202
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.