Information Collection

Evaluation of the Toolkit to Support Evidence-Based Algebra Instruction in Middle and High School

IC 260926 under ICR 202404-1850-004 · OMB 1850-0988.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation of the Toolkit to Support Evidence-Based Algebra Instruction in Middle and High School	Form and Instruction
Teacher Survey Appendix C. Teacher survey.docx	Form and Instruction
Teacher Survey Appendix C. Teacher survey.docx	Form and Instruction
Teacher Implementation Logs Appendix D. Teacher implementation logs.docx	Form and Instruction
Teacher Implementation Logs Appendix D. Teacher implementation logs.docx	Form and Instruction
Instructional Leader Implementation Log Appendix E. Instructional leader implementation logs.docx	Form and Instruction
Instructional Leader Implementation Log Appendix E. Instructional leader implementation logs.docx	Form and Instruction
Instructional Leader Interview Protocol Appendix F. Instructional leader interview protocol.docx	Form and Instruction
Instructional Leader Interview Protocol Appendix F. Instructional leader interview protocol.docx	Form and Instruction
Teacher Focus Group Protocol Appendix G. Teacher focus group protocol.docx	Form and Instruction
Teacher Focus Group Protocol Appendix G. Teacher focus group protocol.docx	Form and Instruction
Student Survey Appendix H. Student survey.docx	Form and Instruction
Student Survey Appendix H. Student survey.docx	Form and Instruction
District Administrative Records Appendix I. District Administrative Records.docx	Form and Instruction
District Administrative Records Appendix I. District Administrative Records.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	NA	Teacher Survey	Appendix C. Teacher survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Teacher Implementation Logs	Appendix D. Teacher implementation logs.docx	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Instructional Leader Implementation Log	Appendix E. Instructional leader implementation logs.docx	Yes	Yes	Fillable Printable
Form and Instruction	NA	Instructional Leader Interview Protocol	Appendix F. Instructional leader interview protocol.docx	Yes	No	Fillable Fileable
Form and Instruction	NA	Teacher Focus Group Protocol	Appendix G. Teacher focus group protocol.docx	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Student Survey	Appendix H. Student survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	NA	District Administrative Records	Appendix I. District Administrative Records.docx	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 466

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 3 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,029	999	30
Annual IC Time Burden (Hours)	358	328	30
Annual IC Cost Burden (Dollars)	0	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.