Head Start Family Voices Pilot Study

Pre-testing of Evaluation Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Document Name Document Type
A1a. Program Recruitment Script.docx Other-Script
A1b. Program Recruitment Screener.docx Other-Screener
A2. Participant Recruitment Form.docx Other-Recruitment Form
A3. Parent Qualitative Interview Protocol - All Modules.docx Other-Protocol
A6. Staff Questionnaire.docx Other-Questionnaire
A5. Parent Questionnaire.docx Other-Questionnare
A4. Staff Qualitative Interview Protocol - All Modules.docx Other-Protocol
HSFV Supporting Statement A 2-26-13 FINAL.docx HSFV Supporting Statement A 2-26-13 FINAL IC Document
HSFV Supporting Statement B 2-26-13 FINAL.docx HSFV Supporting Statement B 2-26-13 FINAL IC Document
Attachments-FINAL.docx Attachments-FINAL IC Document
B1-B2-B3-C1-combined.docx B1-B2-B3-C1-combined IC Document

Information Collection (IC) Details

IC Title:	Head Start Family Voices Pilot Study	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Script	A1a. Program Recruitment Script.docx	Yes	Yes	Fillable Fileable
Other-Screener	A1b. Program Recruitment Screener.docx	Yes	Yes	Fillable Fileable
Other-Recruitment Form	A2. Participant Recruitment Form.docx	Yes	Yes	Fillable Fileable
Other-Protocol	A3. Parent Qualitative Interview Protocol - All Modules.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	A6. Staff Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Questionnare	A5. Parent Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Protocol	A4. Staff Qualitative Interview Protocol - All Modules.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 380	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	341	341
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HSFV Supporting Statement A 2-26-13 FINAL	HSFV Supporting Statement A 2-26-13 FINAL.docx	02/26/2013
HSFV Supporting Statement B 2-26-13 FINAL	HSFV Supporting Statement B 2-26-13 FINAL.docx	02/26/2013
Attachments-FINAL	Attachments-FINAL.docx	02/26/2013
B1-B2-B3-C1-combined	B1-B2-B3-C1-combined.docx	02/26/2013

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