Generic Clearance Submission Template

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 ExpDate: 05/2021)
TITLE OF INFORMATION COLLECTION:  NIH Office of Intramural Training & Education (OITE) – Graduate & Professional School Fair – Student Feedback

PURPOSE:  
The OITE provides several services to the NIH trainees (summer interns, postbaccalaureates, graduate students, postdoctorates, clinical fellows, and research fellows) and NIH staff (staff scientists and staff clinicians) by providing services that cover major topics such as: communication, career development, leadership, mentoring and other personal development.  

The Graduate & Professional School Fair is designed to provide participants of the NIH Summer Internship Program (SIP), NIH Postbaccalaureate Training Program (PBT), and college students across the country, the opportunity to learn more about career exploration and taking the next step in an advanced degree programs leading to a PhD, MD, DDS, MD/PhD, and other graduate and professional degrees.  Approximately 300 outstanding colleges and universities from across the United States discuss their graduate, medical, and dental schools, schools of public health, and other biomedically relevant programs.  This event includes workshops on getting to graduate and professional school, MD/PhD programs, interviewing, and careers in public health, psychology, and dentistry.

DESCRIPTION OF RESPONDENTS: 
The NIH/OITE requests feedback from all participants of the Graduate & Professional School Fair.  Based on past experience, the estimated response rate on the participant feedback form will be less than 25% of the estimated registration count of 5000 participants.

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: Patricia Wagner, PhD [email protected]; 240-476-3619

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  


ESTIMATED BURDEN HOURS and COSTS

Category of Respondent 
No. of Respondents
No. of Responses per Respondent 
Time per 
Response 
(in hours) 
Total Burden
Hours 
Individual (General Public)
1,000
1
14 / 60
234
Individual (NIH Trainees)
250
1
14 / 60
58
Totals
1,250
1,250

292
The Hourly Wage Rate was estimated based on the NIH Trainee Stipend Tables and distribution of the trainee type participating in the OITE events.  Details about the NIH Trainee Stipend tables may be found at: https://oma1.od.nih.gov/manualchapters/person/2300-320-7/. 3

 Category of Respondent
Total Burden
Hours
Hourly Wage Rate*
Total Burden Cost 
Individual (General Public)
234
$14.62
$3,421.00
Individual (NIH Trainees)
58
$14.62
$848.00
Totals


$4,269.00


FEDERAL COST:  The estimated annual cost to the Federal government is $288.00. 

Staff
Grade/Step
Salary
% of Effort
Fringe (if applicable)
Total Cost to Gov’t
Federal Oversight





Employee-1
G13-S01
$103,00.00
0.10%
~
$103.00
Employee-3
Title 42
$185,000.00
0.10%
~
$185.00
Contractor Cost





~
~
~
~
~
~
Travel
~
~
~
~
~
Other Cost
~
~
~
~
~
Total Cost
~
~
~
~
$288.00
The NIH Federal Employee and Contractor Salaries were estimated based on the locality pay for the DC-MD-VA-WV-PA salary table: https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2021/DCB.pdf. 

                         

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?											[X] Yes	[ ] 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 OITE will ask all participants of the Graduate & Professional School Fair to complete the feedback form.

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