Justification Document

Request for Approval under the “DOI Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery”

(OMB Control Number: 1090-0011)

TITLE OF INFORMATION COLLECTION:

Art For The Parks Program Evaluation

PURPOSE:

This survey is to help us improve the National Park Service “Art For Parks” school program hosted by the Fairbanks Alaska Public Lands Information Center. The information collected will be used to make changes in the presentation to better fit the need of our audience.

DESCRIPTION OF RESPONDENTS:

Teachers whose classes that we have visited as part of our “Art For Parks” school program.

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: /s/ Samuel Durbin

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

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 [X] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [X] 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 Hours
Teachers	25	10 min	4.17
Totals	25	10 min	4.17

FEDERAL COST: The estimated annual cost to the Federal government $146.75 (25 submissions x $5.87/each).

	Hourly Pay Rate (OPM “RUS” salary table)	Hourly Rate with Benefits (multiplier of 1.5)	Average Minutes/ Application	Average Cost/ Submission
GS-09/01	$23.46	$35.19	10	$5.87
Total Federal Cost/Submission:				$5.87

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? 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.

[X] Yes [ ] No

We will be sampling all teachers participating in the NPS “Art for the Parks” program in their classroom.

Administration of the Instrument

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

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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