Information Collection

NCCC Impact Studies

IC 236814 under ICR 202201-3045-003 · OMB 3045-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0189 can be found here:

2022-12-23 - Revision of a currently approved collection

Documents and Forms

Document Name Document Type
Form 1 NCCC Impact Studies Form and Instruction
1 Leadership Survey Instrument 1_NCCC Leadership Development Baseline Questionnaire.docx www.nationalservice.gov Form and Instruction
1 Leadership Survey Instrument 1_NCCC Leadership Development Baseline Questionnaire.docx www.nationalservice.gov Form and Instruction
2 Leadership Follow-up 1 Instrument 2 _NCCC Leadership Development Corps Member Early Exit Short Questionnaire.docx www.nationalservice.gov Form and Instruction
2 Leadership Follow-up 1 Instrument 2 _NCCC Leadership Development Corps Member Early Exit Short Questionnaire.docx www.nationalservice.gov Form and Instruction
3 Leadership Follow-up 2 Instrument 3_NCCC Leadership Development First Follow.docx www.nationalservice.gov Form and Instruction
3 Leadership Follow-up 2 Instrument 3_NCCC Leadership Development First Follow.docx www.nationalservice.gov Form and Instruction
4 Corps Member Early Exit Instrument 4_NCCC Leadership Development Second Follow.docx www.nationalservice.gov Form and Instruction
4 Corps Member Early Exit Instrument 4_NCCC Leadership Development Second Follow.docx www.nationalservice.gov Form and Instruction
5 Leadership and Retention Qaulitative Instrument 5_NCCC Focus Groups and Interviews Questions Strengthening Communities by Target Group.docx www.nationalservice.gov Form and Instruction
5 Leadership and Retention Qaulitative Instrument 5_NCCC Focus Groups and Interviews Questions Strengthening Communities by Target Group.docx www.nationalservice.gov Form and Instruction
6 Leadership Surveys with COVID-19 Questions Leadership Surveys 12.06.2019 _modification with track changes.docx www.nationalservice.gov Form and Instruction
6 Leadership Surveys with COVID-19 Questions Leadership Surveys 12.06.2019 _modification with track changes.docx www.nationalservice.gov Form and Instruction
7 Leadership Survey with Additional COVID-19 Questions Leadership Surveys 12.06.2019 _modification with track changes 06.12.20.docx www.nationalservice.gov Form and Instruction
7 Leadership Survey with Additional COVID-19 Questions Leadership Surveys 12.06.2019 _modification with track changes 06.12.20.docx www.nationalservice.gov Form and Instruction
8 Table of Questions with Changes Tracked Table - original instrument + edits in tracked changes.docx www.americorps.gov Form
8 Table of Questions with Changes Tracked Table - original instrument + edits in tracked changes.docx www.americorps.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NCCC Impact Studies	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Leadership Survey	Instrument 1_NCCC Leadership Development Baseline Questionnaire.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	2	Leadership Follow-up 1	Instrument 2 _NCCC Leadership Development Corps Member Early Exit Short Questionnaire.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	3	Leadership Follow-up 2	Instrument 3_NCCC Leadership Development First Follow.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	4	Corps Member Early Exit	Instrument 4_NCCC Leadership Development Second Follow.docx	www.nationalservice.gov	Yes	Yes	Fillable Printable
Form and Instruction	5	Leadership and Retention Qaulitative	Instrument 5_NCCC Focus Groups and Interviews Questions Strengthening Communities by Target Group.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	6	Leadership Surveys with COVID-19 Questions	Leadership Surveys 12.06.2019 _modification with track changes.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form and Instruction	7	Leadership Survey with Additional COVID-19 Questions	Leadership Surveys 12.06.2019 _modification with track changes 06.12.20.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Form	8	Table of Questions with Changes Tracked	Table - original instrument + edits in tracked changes.docx	www.americorps.gov	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,908	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	7,908	5,355	2,553
Annual IC Time Burden (Hours)	3,295	2,295	1,000
Annual IC Cost Burden (Dollars)	188,922	188,922	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.