Information Collection

Diagnostic Assessment System in Georgia Focus Group and Surveys

IC 233088 under ICR 201809-1850-006 · OMB 1850-0946.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Diagnostic Assessment System in Georgia Focus Group and Surveys	Form and Instruction
Teacher Consequential Validity Survey Appendix C - Teacher Consequential Validity Survey 10-24-18.docx	Form
Focus Group Questions Appendix D - Focus Group Plan and Questions 10-24-18.docx	Form and Instruction
IKAN/GloSS Sample Items Appendix B - Sample Items 7-10-18.docx	Form
Appendix A - Approved Teacher Consent and Demographic Form 7-19-18.docx Teacher Consent and Demographic Form	IC Document
Appendix E - District School MOU 7-10-18.docx District School MOU	IC Document
Appendix G - Approved Parent Information Letter and Opt In 7-19-18.docx Parent Information Letter	IC Document
Appendix F - Frequently Asked Questions 7-10-18.docx FAQ	IC Document
Appendix H - Approved Student Assent Form 7-19-18.docx Student Assent Form	IC Document

IC Title:

Agency IC Tracking Number:

ED-2018-ICCD-0087

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?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Focus Group Questions	Appendix D - Focus Group Plan and Questions 10-24-18.docx	No		Paper Only
Form	N/A	IKAN/GloSS Sample Items	Appendix B - Sample Items 7-10-18.docx	No		Paper Only
Form	N/A	Teacher Consequential Validity Survey	Appendix C - Teacher Consequential Validity Survey 10-24-18.docx	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 44

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	44	44
Annual IC Time Burden (Hours)	606	606
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Teacher Consent and Demographic Form	Appendix A - Approved Teacher Consent and Demographic Form 7-19-18.docx	09/19/2018
District School MOU	Appendix E - District School MOU 7-10-18.docx	09/19/2018
Parent Information Letter	Appendix G - Approved Parent Information Letter and Opt In 7-19-18.docx	09/19/2018
FAQ	Appendix F - Frequently Asked Questions 7-10-18.docx	09/19/2018
Student Assent Form	Appendix H - Approved Student Assent Form 7-19-18.docx	09/19/2018

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