Information Collection

Surveys, Coaching Log, Interview, Student Attendance Records Request, Administrative Records Request

IC 247784 under ICR 202106-1850-001 · OMB 1850-0966.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Surveys, Coaching Log, Interview, Student Attendance Records Request, Administrative Records Request	Form and Instruction
Afterschool Center Director Survey APPENDIX B_Afterschool Center Director Survey.docx	Form and Instruction
Afterschool Center Director Survey APPENDIX B_Afterschool Center Director Survey.docx	Form and Instruction
Afterschool Center Coaching Log APPENDIX C_Afterschool Center Coaching Log.docx	Form and Instruction
Afterschool Center Coaching Log APPENDIX C_Afterschool Center Coaching Log.docx	Form and Instruction
Afterschool Center Director Interview APPENDIX D_Afterschool Center Director Interview.docx	Form and Instruction
Afterschool Center Director Interview APPENDIX D_Afterschool Center Director Interview.docx	Form and Instruction
Request for Student Afterschool Attendance Records APPENDIX E_Request for Student Afterschool Attendance Records.docx	Form and Instruction
Request for Student Afterschool Attendance Records APPENDIX E_Request for Student Afterschool Attendance Records.docx	Form and Instruction
Request for District Administrative Records APPENDIX F_Request for District Administrative Records.docx	Form and Instruction
Request for District Administrative Records APPENDIX F_Request for District Administrative Records.docx	Form and Instruction
Afterschool Center Staff Survey APPENDIX G_Afterschool Center Staff Survey.docx	Form and Instruction
Afterschool Center Staff Survey APPENDIX G_Afterschool Center Staff Survey.docx	Form and Instruction
Student Survey APPENDIX H_Student Survey.docx	Form and Instruction
Student Survey APPENDIX H_Student Survey.docx	Form and Instruction
School-Day Teacher Survey APPENDIX I_School-Day Teacher Survey.docx	Form and Instruction
School-Day Teacher Survey APPENDIX I_School-Day Teacher Survey.docx	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Surveys, Coaching Log, Interview, Student Attendance Records Request, Administrative Records Request

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	N/A	Afterschool Center Director Survey	APPENDIX B_Afterschool Center Director Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Afterschool Center Coaching Log	APPENDIX C_Afterschool Center Coaching Log.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Afterschool Center Director Interview	APPENDIX D_Afterschool Center Director Interview.docx	No		Paper Only
Form and Instruction	N/A	Request for Student Afterschool Attendance Records	APPENDIX E_Request for Student Afterschool Attendance Records.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Request for District Administrative Records	APPENDIX F_Request for District Administrative Records.docx	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Afterschool Center Staff Survey	APPENDIX G_Afterschool Center Staff Survey.docx	No		Paper Only
Form and Instruction	N/A	Student Survey	APPENDIX H_Student Survey.docx	No		Paper Only
Form and Instruction	N/A	School-Day Teacher Survey	APPENDIX I_School-Day Teacher Survey.docx	No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,922

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	1,922	1,922
Annual IC Time Burden (Hours)	707	707
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.