NASA EDC_Passive Consent Notice

NASA & U.S. Department of Education 21st Century Community Learning Centers Collaboration Phase 4: NASA Engineering Design Challenges

Passive Consent for Student Data Evaluation Parental Passive Consent

Dear Parent:

Thanks for registering you child(ren) to participate in the NASA an U.S. Department of Education 21st Century Community Learning Collaboration Phase 4 out-of-school Science, Technology, Engineering, and Math (STEM) Engineering Design Challenge program. As part of this program, we will be collecting information in order to evaluate the program's overall goals and objectives: increasing students' interest and motivation in STEM while also working as a team to showcase their skills by participating in an exciting engineering science and space project. The information that we obtain through the evaluation will enable NASA and the U.S. Department of Education to understand how best to deliver the course content in out-of-school environments.

The survey is anonymous and voluntary there will be no identifying information on the surveys your child completes. Your child(ren)'s participation in the course does not depend on answering the questions. Your child does not have to fill out any part of the questionnaire that makes him or her feel uncomfortable or that or that you think your child should not answer. The program will benefit from this survey to the extent that we can identify best practices in the delivery of STEM-related programs that have the greatest chance of increasing students' interest and motivation in STEM classes and careers. If for any reason you do not wish your son or daughter to participate in the evaluation, please sign this form and return it within the first 72 hours of the program.

Student's Name (please print):

Parent Signature:

Date: Time:

Site Name:

State Name:

Privacy Notice: This is not a government application, the application is controlled and operated by a third party. NASA’s Web Privacy Policy does not apply to this application. NASA will not maintain, use, or share Personally Identifiable Information (PII) that becomes available through the use of this third-party application unless expressly stated and consent is obtained from the user. For additional information on NASA’s Third-Party Privacy Notice please go to

http://www.nasa.gov/about/highlights/HP_Privacy.html.

Paperwork Reduction Act Statement: This information collection meets the requirements of 44

U.S.C. §3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 2700-0159 and expires 06/30/2021. We estimate that it will take 15 minutes to read the instructions and answer the questions. Send only comments relating to this time estimate to: [email protected].