Student Data Collection

Impact Study: Lessons in Character Program

Documents and Forms

Document Name Document Type
Student Data Collection Form and Instruction
Student Report Survey Att_LIC Student Survey.doc Form and Instruction
Student LIC Assent Form Att_LIC Student Assent Form.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Student Data Collection	Agency IC Tracking Number:	4220

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	N/A	Student Report Survey	Att_LIC Student Survey.doc		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Student LIC Assent Form	Att_LIC Student Assent Form.doc		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: 10,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 28 %

	Approved	Previously Approved
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	5,833	5,833
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.