1024-0224 NPS Programmatic Form

NPS Form 10-201 (Rev. 09/2019)
National Park Service

OMB Control No. 1024-0224
Expiration Date XX/XX/20XX

Programmatic Clearance Process
For NPS-Sponsored Public Surveys

The scope of the Programmatic Review and Clearance Process for NPS-Sponsored Public Surveys is limited and will only include
individual surveys of park visitors, potential park visitors, and residents of communities near parks. Use of the programmatic review will
be limited to non-controversial surveys of park visitors, potential park visitors, and/or residents of communities near parks that are not
likely to include topics of significant interest in the review process. Additionally, this process is limited to non-controversial information
collections that do not attract attention to significant, sensitive, or political issues. Examples of significant, sensitive, or political issues
include: seeking opinions regarding political figures; obtaining citizen feedback related to high-visibility or high-impact issues like the
reintroduction of wolves in Yellowstone National Park, the delisting of specific Endangered Species, or drilling in the Arctic National
Wildlife Refuge.
Do not revise any part of this form
General Information
Project Title:

Submission Date:

Abstract (not to exceed 150 words)

Principal Investigator Contact Information
Name:

Title:

Affiliation:

Address:

Phone:

Email:

Park or Program Liaison Contact Information
Name:

Title:

Park:

Address:

Phone:

Email:

Project Information
Where will the collection take place? (Name of NPS Site)

Sampling Period Start Date:

Sampling Period End Date:

RECORDS RETENTION - PERMANENT. Transfer all permanent records to NARA 15 years after closure. (NPS Records Schedule,
National Assistance Programs (Item 8.A.2) (N1-79-08-7))

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NPS Form 10-201 (Rev. 09/2019)
National Park Service

OMB Control No. 1024-0224
Expiration Date 11/11/2019

Type of Information Collection Instrument (Check ALL that Apply)

Mail-Back Questionnaire

Face-to-Face Interview

Focus Groups

On-Site Questionnaire

Telephone Survey

Other (list)

Will an electronic device be used to collect information?

No

Yes – type of device __________________________

Survey Justification
Social science research in support of park planning and management is mandated in the NPS Management Policies 2006 (Section
8.11.1, “Social Science Studies”). The NPS pursues a policy that facilitates social science studies in support of the NPS mission to
protect resources and enhance the enjoyment of present and future generations (National Park Service Act of 1916, 38 Stat 535, 16
USC 1, et seq.). NPS policy mandates that social science research will be used to provide an understanding of park visitors, the nonvisiting public, gateway communities and regions, and human interactions with park resources. Such studies are needed to provide a
scientific basis for park planning and development.

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NPS Form 10-201 (Rev. 09/2019)
National Park Service

OMB Control No. 1024-0224
Expiration Date 11/11/2019

Survey Methodology
a. Respondent Universe

b. Sampling Plan/Procedures:

c. Instrument Administration

d. Expected Response Rate/Confidence Levels

Location

Number of

Expected

Expected Number

Margin of

Confidence

Initial Contacts

Response Rate

of Responses

Error +/-%

Level

TOTAL
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NPS Form 10-201 (Rev. 09/2019)
National Park Service

OMB Control No. 1024-0224
Expiration Date 11/11/2019

e. Strategies for dealing with potential non-response bias

f. Description of any pre-testing and peer review of the methods and/or instrument (recommended)

Burden Estimates

Estimated Total Number

Estimation of Time to

Estimation of Burden to

Complete (minutes)

Complete (hours)

Initial Contact
On-site
Refusal/nonresponse
Responses
Total

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NPS Form 10-201 (Rev. 09/2019)
National Park Service

OMB Control No. 1024-0224
Expiration Date 11/11/2019

Reporting Plan

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