Information Collection

Educator Outcome Survey

IC 201401 under ICR 201203-0920-002 · OMB 0920-0941.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0941 can be found here:

Documents and Forms

Document Name Document Type
Form I Educator Outcome Survey Form and Instruction
I Educator Outcome Survey Atmt I Educator Outcome Survey_11-21-11.docx Form and Instruction
Atmt RRR Screen Shots Educator Survey_11-22-11 BT.doc Atmt RRR Screen Shots Educator Survey_11-22-11 BT IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Educator Outcome Survey	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	I	Educator Outcome Survey	Atmt I Educator Outcome Survey_11-21-11.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,584	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	3,168	3,168
Annual IC Time Burden (Hours)	1,584	1,584
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Atmt RRR Screen Shots Educator Survey_11-22-11 BT	Atmt RRR Screen Shots Educator Survey_11-22-11 BT.doc	02/27/2012

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