Template Description VJF Post Event Survey

Request for Approval Under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0960-0788)

TITLE OF INFORMATION COLLECTION: Virtual Job Fair (VJF) Post-Event Surveys

PURPOSE:

Ticket to Work (TTW) is a Social Security Administration (SSA) program that offers adults, ages 18-64, who receive Social Security disability insurance (SSDI) benefits or Supplemental Security Income (SSI) payments due to disability or blindness choices for receiving employment services. Under this program, SSA issues ”tickets” to eligible recipients, who in turn, may choose to assign their tickets to an employment network (EN) or to their State vocational rehabilitation agency (SVRA) to obtain employment services, vocational rehabilitation services, or other support services necessary to achieve their employment goal.

SSA is implementing a campaign that positions the TTW program to take advantage of increased employment opportunities for individuals with disabilities - specifically among Federal contractors and subcontractors responding to the regulatory changes to Section 503 of the Rehabilitation Act of 1973. One component of the campaign is a series of virtual job fairs (VJFs) to connect beneficiaries that have assigned their tickets to SVRAs or ENs with jobs available through Federal contractors and subcontractors.

After each event, SSA will email all participants to thank them for their participation and request their feedback via an online survey questionnaire. We will vary the survey questions based on the participant type (beneficiary, Federal contractor, or service provider) and will include questions about the participant’s experience with the VJF including any accessibility concerns, suggestions for improvements and outcomes, including interviews and job offers.

DESCRIPTION OF RESPONDENTS: The respondents include all participants of the virtual job fairs, including TTW participants, service providers, and Federal contractors.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Faye Lipsky, Reports Clearance Officer, Social Security Administration

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Beneficiaries	9,375	10	1,563
Service Providers	500	10	83
Federal Contractors	125	10	21
Totals	10,000		1,667

FEDERAL COST: The estimated annual cost to the Federal government is _$0___________

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [ X] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

All participants of the virtual job fairs, including TTW program participants, service providers, and Federal contractors.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ X] No

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