Information Collection

Random Assignment Evaluation of Pacific CHILD

IC 181897 under ICR 200709-1850-001 · OMB 1850-0847.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1850-0847 can be found here:

Documents and Forms

Document Name Document Type
Random Assignment Evaluation of Pacific CHILD Form and Instruction
Teacher Survey Att_Appendix ATeacher Survey.pdf Form and Instruction
Impact Survey Att_Appendix B_Impact Survey(3368).pdf Form
Teacher Focus Att_Appendix D_Teacher Focus Group Guide(3368).pdf Form
Teacher Interview Att_Appendix E_Teacher Interview Guide(3368).pdf Form
PREL Staff Focus Group Att_Appendix F_PREL Staff Focus Group Guide(3368).pdf Form
Professional Development Att_Appendix G_Professional Development Protocol(3368).pdf Form
Clasroom Observation Att_Appendix H_SIOP Classroom observation Instrument(3368).pdf Form
Consent Forms and Information Sheet Att_Appendix I_ConsentForms and Information Sheet(3368).pdf Form
Letters of Interest Att_Appendix K_Letters of Interest(3368).pdf Form
SAmple MOU Att_Appendix L_Sample MOU(3368).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Random Assignment Evaluation of Pacific CHILD	Agency IC Tracking Number:	3368

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Teacher Survey	Att_Appendix ATeacher Survey.pdf	Yes	Yes	Fillable Fileable
Form	N/A	Impact Survey	Att_Appendix B_Impact Survey(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Teacher Focus	Att_Appendix D_Teacher Focus Group Guide(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Teacher Interview	Att_Appendix E_Teacher Interview Guide(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	PREL Staff Focus Group	Att_Appendix F_PREL Staff Focus Group Guide(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Professional Development	Att_Appendix G_Professional Development Protocol(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Clasroom Observation	Att_Appendix H_SIOP Classroom observation Instrument(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Consent Forms and Information Sheet	Att_Appendix I_ConsentForms and Information Sheet(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	Letters of Interest	Att_Appendix K_Letters of Interest(3368).pdf	Yes	Yes	Fillable Fileable
Form	N/A	SAmple MOU	Att_Appendix L_Sample MOU(3368).pdf	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 205	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 74 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	205	205
Annual IC Time Burden (Hours)	211	211
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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