DoDEA Customer Satisfaction Survey - Students - One-Pager

Request for Approval under the “Fast Track Generic Clearance for the
Collection of Routine Customer Feedback” (OMB Control Number: 5)
TITLE OF INFORMATION COLLECTION:
DoDEA Customer Satisfaction Survey
PURPOSE:
The biennial DoDEA Customer Satisfaction Survey (CSS) is a critical component of DoDEA’s Blueprint for
Success. It is the agency’s principle means for measuring the satisfaction level of students, parents and teachers
with the quality of teaching, learning, programs and services available in DoDEA schools. The data will be
used to inform decision-making at every level of the organization to help ensure the quality of teaching and
learning and to improve programs and services offered to DoDEA's students. The results will also be used to
monitor progress on the goals of DoDEA’s strategic plan.

DESCRIPTION OF RESPONDENTS:
The CSS will be administered biennially to currently enrolled DoDEA students in grades 4 through 12, their
parents/sponsors, and educators at all DoDEA schools. Every potential respondent in these categories will be
invited to complete a survey.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[X] Customer Satisfaction Survey
[ ] Small Discussion 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:______________________________________________________
MOELLMER.WILLIAM.A.1401655995 Digitally signed by MOELLMER.WILLIAM.A.1401655995
Date: 2019.02.25 07:15:30 -05'00'

1

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

No. of
Participation
Respondents Time
12,465
30 min
12,465

Totals

30 min

Burden
6,233
6,233

PUBLIC COST: The estimated annual cost to the public is $45,185.63.
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?
[ ] Yes [X] No
If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is
no, please provide a description of how you plan to identify your potential group of respondents and how you
will select them?
The CSS will be administered biennially to currently enrolled DoDEA students in grades 4 through 12, their
parents/sponsors, and educators at all DoDEA schools. Every potential respondent in these categories will be
identified using administrative data housed at DoDEA and all potential participants will be invited to complete a
survey.
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.
2

Instructions for completing Request for Approval under the “Generic Clearance for the
Collection of Routine Customer Feedback”
TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the
request. (e.g. Comment card for soliciting feedback on xxxx)
PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part
of a larger study or effort, please include this in your explanation.
DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this
collection of information. These groups must have experience with the program.
TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the
generic, you must complete a form for each instrument.
CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be
returned as improperly submitted or it will be disapproved.
Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect
PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a
specific objective.
Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification
for the amount.
BURDEN HOURS:
Category of Respondents: Identify who you expect the respondents to be in terms of the following categories:
(1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal
Government. Only one type of respondent can be selected per row.
No. of Respondents: Provide an estimate of the Number of respondents.
Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill
out a survey or participate in a focus group)
Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and
divide by 60.
PUBLIC COST: Provide an estimate of the annual cost to the Public.
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. Please provide a description of how you plan to identify your
potential group of respondents and how you will select them. If the answer is yes, to the first question, you may
provide the sampling plan in an attachment.
Administration of the Instrument: Identify how the information will be collected. More than one box may
be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups)
used.
Submit all instruments, instructions, and scripts with the Request for Approval.

3