Generic Template - Grantee Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1800-0011)

T ITLE OF INFORMATION COLLECTION: U.S. Department of Education Charter Schools Program Meeting of Project Directors (2012)

PURPOSE: The U.S. Department of Education (ED) has as one of its many policy goals expanding the number high-quality public school choice options. Specifically, according to Part B section 5201 of the Elementary and Secondary Education Act, two of the established purposes of the Charter School Program (CSP) office are: evaluating the effects of such schools, including the effects on students, student academic achievement, staff and parents, and expanding the number of high-quality charter schools available to students across the nation.

In support of CSP grantees, an annual Project Directors Meeting is held, providing technical assistance on grant activities, and a chance for networking and conversation. To ensure that this annual meeting continues to be relevant and helpful to grantees, a survey will be administered post-conference and be used to improve future Project Directors Meetings.

DESCRIPTION OF RESPONDENTS: Surveys will be handed out to participants at the conference, with an electronic follow-up to capture all responses. Respondents will be project directors from the CSP grant programs (84.282A, 84.282B, 84.282C, 84.282M, and 84.282N).

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:__Erin Pfeltz______________________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Project Directors	150	15 minutes	37 hours
Totals	150	15 minutes	37 hours

FEDERAL COST: The estimated annual cost to the Federal government is _$1,312.50___________

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [ X] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[X ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

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