Add Us In Survey Advance Notice

Survey about the Engagement of Partners in the

[INSERT NAME OF ADD-US-IN CONSORITA HERE]

Advance Notice for a Web-Based Survey

[DATE]

As part of an effort to understand the partnerships in the [INSERT NAME OF ADD-US-IN CONSORTIA HERE], the Office of Disability Employment Policy of the U.S. Department of Labor (DOL-ODEP) is conducting the Survey of Partner Engagement. IMPAQ International, LLC is administering the Survey of Partner Engagement for DOL-ODEP. IMPAQ is an independent research firm with more than 10 years of experience in providing program evaluation and data collection services to DOL and other Federal and state agencies. This data collection effort is approved by the U.S. Office of Management and Budget under OMB Control No. 1225-0059 expiration date: 01/31/2016.

The purpose of the Survey of Partner Engagement is to gather information about the work and collaboration of [INSERT NAME OF ADD-US-IN CONSORTIA HERE] partners, and whether they have experienced any change in how they think or what they do when they interact with individuals with disabilities. The survey should only take about fifteen minutes to complete and your participation is voluntary. Your answers will be kept private to the extent permitted by law, you will not be asked to provide personal identifiers such as your name or address, and you will never be identified in any report based on the survey.

Within the next few days, you will receive an email with an invitation to participate in the online survey. The email will come from XXXX@impaqint.com and the subject line will read Survey of Partner Engagement. We encourage you to take a few minutes to complete this survey. Your organization’s experience is important, and this is your opportunity to share your ideas with the DOL-ODEP.

IMPAQ staff will follow-up with you via email to confirm your participation and to answer any questions you may have. In the meantime, if you would like to discuss your participation in the Survey of Partner Engagement, please call Lisa Lin-Freeman from IMPAQ at (443) 539-1396 or llfreeman@impaqint.com.

We sincerely appreciate your attention to this research and look forward to your feedback!

Paperwork Reduction Act Statement

A Federal agency may not conduct or sponsor, and a person is not required to respond to this collection of information, unless it displays a currently valid OMB control number. Your obligation to reply to this survey is voluntary. The public burden for this survey is estimated at 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the necessary data, and completing and reviewing the collection of information. Send comments concerning this burden estimate or any other aspect of this collection of information to the US Dept. of Labor, Office of Disability Employment Policy, 200 Constitution Ave, Washington DC 20210.

OMB Control Number: 1225-0059 Expiration Date: 01/31/2016