Information Collection

Evaluation of the Early Warning and Intervention Monitoring System (EWIMS)

IC 210269 under ICR 201402-1850-002 · OMB 1850-0907.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1850-0907 can be found here:

Documents and Forms

Document Name Document Type
Evaluation of the Early Warning and Intervention Monitoring System (EWIMS) Form
Staff Survey CBStaff survey.pdf Form
Student Survey RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-2 Student Survey.pdf Form
Extant Data RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-1 Extant Data Request.pdf Form
March Interview RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-3 Interview Protocol.pdf Form
Request for Extant RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-4 Request for Extant Documents.pdf Form
Focus Group RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-6 Focus Group Protocol.pdf Form
Study Staff Survey RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-7 Focus Group Protocol.pdf Form
IC Data Part II RELMW 4 2 09 Ramp-Up Implementation Study OMB_ICR_Part II_Addendum.docx Form
Instructional Log RELMW 4 2 09 Ramp-Up Implementation Study OMBIC-5 Instructional log.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Evaluation of the Early Warning and Intervention Monitoring System (EWIMS)	Agency IC Tracking Number:

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	n/a	Staff Survey	CBStaff survey.pdf	Yes	Yes	Paper Only
Form	n/a	Student Survey	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-2 Student Survey.pdf	Yes	Yes	Paper Only
Form	n/a	Extant Data	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-1 Extant Data Request.pdf	Yes	Yes	Paper Only
Form	n/a	March Interview	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-3 Interview Protocol.pdf	Yes	Yes	Fillable Printable
Form	n/a	Request for Extant	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-4 Request for Extant Documents.pdf	Yes	Yes	Fillable Printable
Form	n/a	Focus Group	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-6 Focus Group Protocol.pdf	Yes	Yes	Fillable Printable
Form	n/a	Study Staff Survey	RELMW 4 2 09 Ramp-Up Implementation Study OMB IC-7 Focus Group Protocol.pdf	Yes	Yes	Paper Only
Form	n/a	IC Data Part II	RELMW 4 2 09 Ramp-Up Implementation Study OMB_ICR_Part II_Addendum.docx	Yes	Yes	Paper Only
Form	n/a	Instructional Log	RELMW 4 2 09 Ramp-Up Implementation Study OMBIC-5 Instructional log.pdf	Yes	Yes	Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,946	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 40 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,086	6,086
Annual IC Time Burden (Hours)	1,212	1,212
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.