Information Collection

Museum Assessment Program (MAP) Impact Survey

IC 220676 under ICR 202211-3137-008 · OMB 3137-0106.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Online Survey 1 Museum Assessment Program (MAP) Impact Survey	Form and Instruction
Form Online Survey 1 Museum Assessment Program (MAP) Impact Survey	Form and Instruction
Online Survey 1 Museum Assessment Program (MAP) Impact Survey AppendixA_OnlineSurvey v4.pdf	Form and Instruction
Online Survey 1 Museum Assessment Program (MAP) Impact Survey AppendixA_OnlineSurvey v4.pdf	Form and Instruction
Paper Survey 1 Museum Assessment Program (MAP) Impact Survey AppendixB_PaperSurvey v4.docx	Form and Instruction
Paper Survey 1 Museum Assessment Program (MAP) Impact Survey AppendixB_PaperSurvey v4.docx	Form and Instruction
AppendixE_SurveyInvite v4.docx Appendix E Survey Invite	IC Document
AppendixE_SurveyInvite v4.docx Appendix E Survey Invite	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Online Survey 1	Museum Assessment Program (MAP) Impact Survey	AppendixA_OnlineSurvey v4.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	Paper Survey 1	Museum Assessment Program (MAP) Impact Survey	AppendixB_PaperSurvey v4.docx		No		Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 255

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	3,197	3,197

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix E Survey Invite	AppendixE_SurveyInvite v4.docx	01/04/2017

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