OSTEM Summit Survey_One-Pager

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: NASA OSTEM Summit Survey

PURPOSE:

NASA OSTEM is planning a summit on December 2^nd for NASA civilian and contractor staff working on education issues. We are focusing this summit on practical steps to help OSTEM in both current and future work.  This survey will help OSTEM planning staff determine what speakers and topics would be most useful.

DESCRIPTION OF RESPONDENTS:

In addition to employees, OSTEM has roughly 200 contractors at both the centers and headquarters who would potentially want to attend.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[X ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: OSTEM Summit Survey

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [] Yes [X] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Government Contractors	200	5 min / each	16.6 hrs
Number of responses per respondent	1
Totals			16.6 hrs.

FEDERAL COST: The direct employee costs were calculated by multiplying estimated aggregate hours spent on the project (3weeks) by the annual pay of one GS-15 Step 10 employee $170,800 x .057 = $9,735. Indirect or overhead costs associated with the project are calculated as 20 percent of the above at $1947.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X ] Yes [] No

All NASA contractors and employees who have worked with the OSTEM enterprise will be emailed via a SurveyMonkey link.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[x ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[] Other, Explain:

2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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