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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Efficacy Evaluation of the Mathematics Intervention Toolkit for the Elementary Grades
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
N/A
Parent/Guardian Informational Letter
Parent_ConsentForm - Active 2023-08-14 ac_09-18-23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Parent/Guardian Informational Letter (Parent/Guardian Opt-Out)
Parent_OptOut rev 2023-08-14 ac_09-18-23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Teacher Consent
Teacher_Consent ac_09-18-23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Student Survey
Student Survey rev2_09-18-23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Teacher End-of-Module Reflection Survey
Teacher End of Module Reflection Survey rev2.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Teacher Math Knowledge for Teaching Assessment
Teacher Math Knowledge for Teaching Assessment rev2.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Teacher Post-Intervention Survey
Teacher Post Intervention Survey rev2 ac_09-18-23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Teacher Pre-Intervention Survey
Teacher Pre Intervention Survey rev2 ac_09-18-23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Teacher Instructional Log
Teacher Instructional Log.docx
Yes
Yes
Fillable Fileable
Other-Burden Statement
NE 5.1.3 MA Public Burden Statement.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Elementary, Secondary, and Vocational Education
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
9,495
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
9,630
0
9,630
0
0
0
Annual IC Time Burden (Hours)
3,106
0
3,106
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.