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21st CCLC facilitator survey
Maker/STEM Education Support for 21st Century Community Learning Centers Program Evaluation
OMB: 3137-0108
IC ID: 227154
OMB.report
IMLS
OMB 3137-0108
ICR 202211-3137-009
IC 227154
( )
Documents and Forms
Document Name
Document Type
Form 21st CCLC facilita
21st CCLC facilitator survey
Form and Instruction
Form 21st CCLC facilita
21st CCLC facilitator survey
Form and Instruction
21st CCLC facilita 21st CCLC facilitator survey form1
Maker STEM Ed Support for 21st CCLC evaluation_5 17 17 - Faciltator online survey instrument Final 20170602.docx
Form and Instruction
21st CCLC facilita 21st CCLC facilitator survey form1
Maker STEM Ed Support for 21st CCLC evaluation_5 17 17 - Faciltator online survey instrument Final 20170602.docx
Form and Instruction
Maker STEM Ed Support for 21st CCLC evaluation_5 17 17 - Facilitator online survey reminder email Final 20170602.docx
21st CCLC facilitator survey email reminder
IC Document
Maker STEM Ed Support for 21st CCLC evaluation_5 17 17 - Facilitator online survey reminder email Final 20170602.docx
21st CCLC facilitator survey email reminder
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
21st CCLC facilitator survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
21st CCLC facilitator survey form 1
21st CCLC facilitator survey form1
Maker STEM Ed Support for 21st CCLC evaluation_5 17 17 - Faciltator online survey instrument Final 20170602.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Cultural and Historic Exhibition
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
30
0
0
0
30
0
Annual IC Time Burden (Hours)
6
0
0
0
6
0
Annual IC Cost Burden (Dollars)
146
0
0
0
146
0
Documents for IC
Title
Document
Date Uploaded
21st CCLC facilitator survey email reminder
Maker STEM Ed Support for 21st CCLC evaluation_5 17 17 - Facilitator online survey reminder email Final 20170602.docx
06/12/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.