Screener Pool Questions 2 rev

Federal Student Aid User Experience Design Research Generic Clearance

Screener Pool Questions 2 rev

OMB: 1845-0159

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dScout Screener Pool questions


  1. Which of the following statements best describe you?

  • I'm a Parent

  • I'm a High School Student

  • I'm a College Undergrad

  • I'm a Grad School Student

  • I'm a Soon-To-Be Grad School Student

  • Other (please describe)



  1. Which one the following statements best describe you?

Current and soon-to-be graduate students – please only count FAFSA applications for your graduate studies.

  • I'm a parent and recently submitted my first-ever Parent PLUS Loan application

  • I'm a parent and I'll be applying for my first-ever Parent PLUS Loan in the next 6 months

  • I recently submitted my first-ever Grad PLUS Loan application

  • I'll be applying for my first-ever Grad PLUS Loan in the next 6 months

  • I recently submitted the FAFSA for the first time

  • I'll be submitting the FAFSA (for the first time) in the next 6 months

  • None of these apply to me


  1. [Text Entry] Please tell us when you submitted – or will be submitting – your first FAFSA and/or PLUS Loan application (example: FAFSA, January 2020)



  1. Selected scouts will be asked to participate in 45-minute interviews. Since these interviews will take place over the next few weeks, we'll need a general idea of when you're available. If provided with advance notice, please indicate when you would most likely be available to speak with us. We understand it's hard to predict the future; your best guess will do just fine! Note, the timeframes below are in Eastern Time.


  • Monday (9am to 1pm)

  • Monday (1pm to 5pm)

  • Tuesday (9am to 1pm)

  • Tuesday (1pm to 5pm)

  • Wednesday (9am to 1pm)

  • Wednesday (1pm to 5pm)

  • Thursday (9am to 1pm)

  • Thursday (1pm to 5pm)

  • Friday (9am to 1pm)

  • Friday (1pm to 5pm)

  • None of these options will ever work for me




  1. This task can only be completed through Microsoft Teams on your desktop or laptop Mac or PC. Are you comfortable using Microsoft Teams (or a similar application) on your Mac or PC?

  • Yes

  • No


  1. Video Entry: In about 30 seconds, tell us about one of your most memorable high school or college moments. Maybe it was something fun, funny, or just interesting. Set the scene for us and share your story!


  1. Text Entry: Lastly, please describe one of the most challenging or one of the most rewarding parts of your experience with the FAFSA, PLUS Loans, or federal student aid.


Additional questions for screener pool


  1. Do you currently have a visual impairment? If so, please indicate the level of severity of your visual impairment. (optional)


  • Very Poor Vision - using a computer is very difficult or impossible without assistive technology

  • Poor Vision - notably impacts your ability to use a computer

  • Moderate Vision - can see adequately with correction (glasses, contact lenses), or not legally blind


  1. Please list any assistive technologies that you use. (optional)

    Free form answer


  1. How did you hear about this survey? (optional)


  • From an FSA website or app

  • At a conference

  • From an association

  • From an advocacy organization


  1. Have you ever been incarcerated? (optional)

  • Yes

  • No


  1. If you have been incarcerated, what situation best describes you? (Check all that apply) (optional)

  • I am currently incarcerated

  • I have been incarcerated in the past, but I am no longer incarcerated

  • None of the above (free form answer)


  1. Have you ever experienced homelessness? (optional)

  • Yes

  • No

  1. If you have experienced homelessness which situation best describes you? (optional)


  • I am/have lived on the street

  • I am/have been living in a shelter

  • I am/have been without a permanent address, but I am living with friends/family

  • I have been homeless in the past, but I am currently not homeless



  1. Are you or your spouse a military veteran?

  • Yes

  • No

  1. Have you experienced homelessness while trying to apply for a Student Loan? (optional)

  • Yes

  • No

  1. If you have applied for a student loan, did you get help from your parents? (optional)

  • Yes

  • No

  1. Did your parents help you fill out the FAFSA? (optional)

  • Yes

  • No


  1. If you answered no, were your parents divorced at the time you filled out the FAFSA? (optional)

  • Yes

  • No


13. What is your degree of hearing difficulty? (optional)


  • Mild - you may hear some speech sounds, but will have difficulty with soft sounds

  • Moderate – you struggle to hear/understand speech when someone is talking at a normal level

  • Severe- you hear little-to-no speech when spoken at normal levels, and hear only some loud sounds

  • Profound – you may only hear very loud sounds and no speech at all

  • Public Burden Statement

  • According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1845-0159.  Public reporting burden for this collection of information is estimated to average 6 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  The obligation to respond to this collection is voluntary.  If you have any comments concerning the accuracy of the time estimate, suggestions for improving this individual collection, or if you have comments or concerns regarding the status of your individual form, application or survey, please contact FSA.brand@ed.gov or 1-800-433-3243 directly.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBeth Grebeldinger
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File Created2023-10-16

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