Information Collection

Community Catalyst (CCI) Program Evaluation

IC 234460 under ICR 201812-3137-001 · OMB 3137-0113.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0113 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 2 Community Catalyst (CCI) Program Evaluation	Form and Instruction
Form 1 CCI Case Study Protocol CCI Case Study Protocol 11.25.2018.docx	Form and Instruction
Form 2 CCI Local Partner Survey CCI Eval Survey for Local Partner Orgs (C1 & C2FU) V2.pdf	Form and Instruction
From 3 CCI Local Partner Survey Cohort Two CCI Eval Survey for Local Partner Orgs (C2B) V2.pdf	Form and Instruction
Form 4 CCI Museum and Library Survey CCI Eval Survey for Museums Libs Other Grantees (C1) V2.pdf	Form and Instruction
Form 5 CCI Museum and Library Survey Cohort Two CCI Eval Survey for Museums Libs Other Grantees (C2B) V2.pdf	Form and Instruction
Form 6 CCI Museum and Library Survey Follow Up CCI Eval Survey for Museums Libs Other Grantees (C2FU) V2.pdf	Form and Instruction
Form 7 CCI Project Team Interview Protocol CCI Project Team Interview Protocol 11.25.18.docx	Form and Instruction
Theory of Change Visual (Part A).pdf CCI Theory of Change	IC Document
CCI Project Research References.docx CCI Research References	IC Document
CCI Evaluation Survey Link Messages and Reminders 11.28.18.docx CCI Survey Link and Correspondence	IC Document

IC Title:

Community Catalyst (CCI) Program Evaluation

Agency IC Tracking Number:

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	Form 2	CCI Local Partner Survey	CCI Eval Survey for Local Partner Orgs (C1 & C2FU) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	From 3	CCI Local Partner Survey Cohort Two	CCI Eval Survey for Local Partner Orgs (C2B) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 4	CCI Museum and Library Survey	CCI Eval Survey for Museums Libs Other Grantees (C1) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 5	CCI Museum and Library Survey Cohort Two	CCI Eval Survey for Museums Libs Other Grantees (C2B) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 6	CCI Museum and Library Survey Follow Up	CCI Eval Survey for Museums Libs Other Grantees (C2FU) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 7	CCI Project Team Interview Protocol	CCI Project Team Interview Protocol 11.25.18.docx	Yes	No	Fillable Printable
Form and Instruction	Form 1	CCI Case Study Protocol	CCI Case Study Protocol 11.25.2018.docx	Yes	No	Fillable Printable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 599

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	599	599
Annual IC Time Burden (Hours)	524	524
Annual IC Cost Burden (Dollars)	16,610	16,610

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CCI Theory of Change	Theory of Change Visual (Part A).pdf	12/10/2018
CCI Research References	CCI Project Research References.docx	12/10/2018
CCI Survey Link and Correspondence	CCI Evaluation Survey Link Messages and Reminders 11.28.18.docx	12/10/2018

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