Information Collection

NASA Office of Education STEM Challenges Impact Surveys:Student Baseline Instruments

IC 223218 under ICR 201804-2700-001 · OMB 2700-0159.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2700-0159 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2-NASA Education SCIS-STUDENT BASELINE INSTRUMENT- SRC.docx	Other-Instrument
3-NASA Education SCIS-STUDENT BASELINE INSTRUMENT- EDC.docx	Other-Instrument
4-NASA Education SCIS- STUDENT SCREENSHOTS- SRC.docx	Other-Instrument ScreenShot
5-NASA Education SCIS- STUDENT SCREENSHOTS- EDC.docx	Other-Instrument ScreenShot
6-NASA Education SCIS- SCRIPT-SRC.docx	Other-Instrument Script
7-NASA Education SCIS- SCRIPT-EDC.docx	Other-Instrument Script
8-NASA Education SCIS- EDUCATOR INSTRUCTIONS-SRC.docx	Instruction
9-NASA Education SCIS- EDUCATOR INSTRUCTIONS-EDC.docx	Instruction
10-NASA Education SCIS- EDUCATOR INSTR SCREENSHOT- SRC.docx	Other-Instrument ScreenShot
11-NASA Education SCIS- EDUCATOR INSTR SCREENSHOT- EDC.docx	Other-Instrument ScreenShot
12-NASA Education SCIS- CONSENT FORM- SRC.docx	Other-Consent Form (Parental)
13-NASA Education SCIS- CONSENT FORM- EDC.docx	Other-Consent Form (Parental)
SHORT FORM. NASA Education STEM Challenges Impact Surveys-Student Baseline Instruments.pdf SHORT FORM. NASA Education STEM Challenges	IC Document
SORN.NASA 10EDUA.NASA Education Records.FRN 15-012.Mar.17.2015.pdf NASA Education SORN	IC Document

IC Title:

NASA Office of Education STEM Challenges Impact Surveys:Student Baseline Instruments

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Instrument	2-NASA Education SCIS-STUDENT BASELINE INSTRUMENT- SRC.docx	Yes	Yes	Fillable Fileable
Other-Instrument	3-NASA Education SCIS-STUDENT BASELINE INSTRUMENT- EDC.docx	Yes	Yes	Fillable Fileable
Other-Instrument ScreenShot	4-NASA Education SCIS- STUDENT SCREENSHOTS- SRC.docx	Yes	Yes	Fillable Fileable
Other-Instrument ScreenShot	5-NASA Education SCIS- STUDENT SCREENSHOTS- EDC.docx	Yes	Yes	Fillable Fileable
Other-Instrument Script	6-NASA Education SCIS- SCRIPT-SRC.docx	Yes	Yes	Fillable Fileable
Other-Instrument Script	7-NASA Education SCIS- SCRIPT-EDC.docx	Yes	Yes	Fillable Fileable
Instruction	8-NASA Education SCIS- EDUCATOR INSTRUCTIONS-SRC.docx	Yes	Yes	Fillable Fileable
Instruction	9-NASA Education SCIS- EDUCATOR INSTRUCTIONS-EDC.docx	Yes	Yes	Fillable Fileable
Other-Instrument ScreenShot	10-NASA Education SCIS- EDUCATOR INSTR SCREENSHOT- SRC.docx	Yes	Yes	Fillable Fileable
Other-Instrument ScreenShot	11-NASA Education SCIS- EDUCATOR INSTR SCREENSHOT- EDC.docx	Yes	Yes	Fillable Fileable
Other-Consent Form (Parental)	12-NASA Education SCIS- CONSENT FORM- SRC.docx	Yes	Yes	Fillable Fileable
Other-Consent Form (Parental)	13-NASA Education SCIS- CONSENT FORM- EDC.docx	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Space Exploration and Innovation

Privacy Act System of Records

Title: NASA 10EDUA, NASA Education Program Evaluation System

FR Citation: 15 FR 12

Number of Respondents: 865

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	865	865
Annual IC Time Burden (Hours)	127	127
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SHORT FORM. NASA Education STEM Challenges	SHORT FORM. NASA Education STEM Challenges Impact Surveys-Student Baseline Instruments.pdf	08/29/2016
NASA Education SORN	SORN.NASA 10EDUA.NASA Education Records.FRN 15-012.Mar.17.2015.pdf	08/29/2016

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