Information Collection

Evaluation of Preschool Special Education Practices Efficacy Study

IC 213317 under ICR 201901-1850-001 · OMB 1850-0916.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix B Class Roster and Data Request Form_clean.docx	Other-Roster and Data Request Form
Appendix C Parent Letter and Consent Form_updated 2-27-19.docx	Other-Letter and Consent form
Appendix D Administrative Records Request Form_clean.docx	Other-Administrative Records request
Appendix E Observation Instruments with Interview Component_clean.docx	Other-Observation Instruments and In
Appendix F Teacher Focus Group Forms and Protocol_clean_revised for IRB.docx	Other-Focus Group Protocol
Appendix G Teacher Background and Experience Survey_3-25-19.docx	Other-Teacher Background and Experie
Appendix H Teacher-Child Reports_clean_revised post IRB.docx	Other-Teacher Child Reports

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Roster and Data Request Form	Appendix B Class Roster and Data Request Form_clean.docx	Yes	Yes	Fillable Fileable
Other-Letter and Consent form	Appendix C Parent Letter and Consent Form_updated 2-27-19.docx	No		Paper Only
Other-Administrative Records request form	Appendix D Administrative Records Request Form_clean.docx	Yes	Yes	Fillable Fileable
Other-Observation Instruments and Interview Component	Appendix E Observation Instruments with Interview Component_clean.docx	No		Paper Only
Other-Focus Group Protocol	Appendix F Teacher Focus Group Forms and Protocol_clean_revised for IRB.docx	No		Paper Only
Other-Teacher Background and Experiences Survey	Appendix G Teacher Background and Experience Survey_3-25-19.docx	No		Paper Only
Other-Teacher Child Reports	Appendix H Teacher-Child Reports_clean_revised post IRB.docx	No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,739

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	1,471	1,471
Annual IC Time Burden (Hours)	466	466
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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