2017-18 Peace Corps Campus Ambassadors Program Exit Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0545 can be found here:

Documents and Forms

Document Name Document Type
Form PC-2180 2017-18 Peace Corps Campus Ambassadors Program Exit Survey Form and Instruction
PC-2180 2017-18 Campus Ambassadors Exit Survey 2017-18 CA Exit Survey in Survey Monkey.pdf Form and Instruction
Fast-track OMB Control Number_2017-18 CA Exit Survey.docx Fast Track submission form IC Document

Information Collection (IC) Details

IC Title:	2017-18 Peace Corps Campus Ambassadors Program Exit Survey	Agency IC Tracking Number:	PC-2180

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PC-2180	2017-18 Campus Ambassadors Exit Survey	2017-18 CA Exit Survey in Survey Monkey.pdf		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 470	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	470	470
Annual IC Time Burden (Hours)	39	39
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track submission form	Fast-track OMB Control Number_2017-18 CA Exit Survey.docx	05/01/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.