Generic Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1880-0542)

TITLE OF INFORMATION COLLECTION: Perkins V Quality Indicators

PURPOSE:

The Quality Indicator Project is a nationwide initiative to build State capacity to implement the Perkins V quality indicators. Project work will inform development of technical assistance materials that States may access online via the Perkins Collaborative Resource Network. Recommendations from Quality Indicator Workgroups (QIWs) comprised of State and local-level CTE directors and staff at the secondary and postsecondary levels will support development of the technical assistance materials. Project work entails convening three QIWs, which will each meet online on a bi-monthly basis between December 2020 and August 2021 to document challenges and possible solutions to issues identified by OCTAE and QIW members (5 meetings/QIW @ 90-minutes/meeting). Following each convening a short online survey will be administered to participants to assess their impression of the event.

DESCRIPTION OF RESPONDENTS:

The respondents are state and local-level CTE directors and staff at the secondary and postsecondary levels who voluntarily choose to participate. This will include 16 individuals who applied for and were accepted to participate as QIW members (total for the three groups) as well as ‘drop ins’ choosing to attend.

TYPE OF COLLECTION: (Check one)

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

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

[] 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: Sherene Donaldson

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

3. If Applicable, has a System or Records Notice 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	No. of Respondents	Participation Time	Burden
State and local-level CTE directors and staff at the secondary and postsecondary levels in QIW 1 @ 5 meetings	Roughly 15 respondents per meeting	5 minutes per respondent per meeting	6.25 hours
State and local-level CTE directors and staff at the secondary and postsecondary levels in QIW 2 @ 5 meetings	Roughly 15 respondents per meeting	5 minutes per respondent per meeting	6.25 hours
State and local-level CTE directors and staff at the secondary and postsecondary levels in QIW 3 @ 5 meetings	Roughly 15 respondents per meeting	5 minutes per respondent per meeting	6.25 hours
Totals	225 respondents	5 minutes per respondent per meeting	18.75 hours

FEDERAL COST: The estimated annual cost to the Federal government is $2,180.85.

We estimate that the Contracting Officer’s Representative (COR) for the Perkins V contract will spend approximately 5 hours on the management and oversight of the activity and that various contractor staff will spend approximately 30 hours on the design and administration of the survey and the analysis of its results. The GS 13 Step 9 hourly rate is used for both COR and contractor averages.

GS Grade	Step 9 Annual Salary	Hourly Rate	Approximate Cost
GS-13	$130.043	$62.31	$2,180.85

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?

We will send out a link to the survey at the end of each virtual meeting. We will make the survey available to all webinar attendees. The survey will be hosted and administered on a separate platform and not be visible to anyone other than the evaluators.

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.

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.

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.

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.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

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.

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

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