Information Collection

Diagnostic Assessment System in Georgia Focus Group and Surveys

IC 233088 under ICR 201809-1850-006 · OMB 1850-0946.

Documents and Forms

Document Name Document Type
Diagnostic Assessment System in Georgia Focus Group and Surveys Form and Instruction
Teacher Consequential Validity Survey Appendix C - Teacher Consequential Validity Survey 10-24-18.docx Form
Focus Group Questions Appendix D - Focus Group Plan and Questions 10-24-18.docx Form and Instruction
IKAN/GloSS Sample Items Appendix B - Sample Items 7-10-18.docx Form
Appendix A - Approved Teacher Consent and Demographic Form 7-19-18.docx Teacher Consent and Demographic Form IC Document
Appendix E - District School MOU 7-10-18.docx District School MOU IC Document
Appendix G - Approved Parent Information Letter and Opt In 7-19-18.docx Parent Information Letter IC Document
Appendix F - Frequently Asked Questions 7-10-18.docx FAQ IC Document
Appendix H - Approved Student Assent Form 7-19-18.docx Student Assent Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Diagnostic Assessment System in Georgia Focus Group and Surveys	Agency IC Tracking Number:	ED-2018-ICCD-0087

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	Focus Group Questions	Appendix D - Focus Group Plan and Questions 10-24-18.docx	No		Paper Only
Form	N/A	IKAN/GloSS Sample Items	Appendix B - Sample Items 7-10-18.docx	No		Paper Only
Form	N/A	Teacher Consequential Validity Survey	Appendix C - Teacher Consequential Validity Survey 10-24-18.docx	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: 44	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	44	44
Annual IC Time Burden (Hours)	606	606
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Teacher Consent and Demographic Form	Appendix A - Approved Teacher Consent and Demographic Form 7-19-18.docx	09/19/2018
District School MOU	Appendix E - District School MOU 7-10-18.docx	09/19/2018
Parent Information Letter	Appendix G - Approved Parent Information Letter and Opt In 7-19-18.docx	09/19/2018
FAQ	Appendix F - Frequently Asked Questions 7-10-18.docx	09/19/2018
Student Assent Form	Appendix H - Approved Student Assent Form 7-19-18.docx	09/19/2018

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