Fast-Track Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp. Date: 03/31/2018)

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TITLE OF INFORMATION COLLECTION: Traveling Exhibition Host Survey

PURPOSE: The Exhibition Program at the National Library of Medicine (NLM) produces banner-style traveling exhibitions that libraries and cultural institutions book and display locally for six weeks. In managing traveling exhibition service, the Exhibition Program maintains all traveling exhibitions tour itineraries that extend to 2018 and beyond, as well as a list of main contacts at the institutions that are booked to host NLM traveling exhibitions.

This request is for the Exhibition Program to gather data from the traveling exhibition host institutions, in order to assess the impact of the traveling exhibition service on the institutions and their audiences, as well as to identify outreach needs for serving community members. To this end, the Program has created an online survey instrument (SurveyMonkey) that will gather information from host institutions about each exhibition booking. The data will help the Exhibition Program:

1. assess estimated numbers and types of visitors to the traveling exhibitions;

2. measure programming activities and use of NLM resources, in conjunction with traveling exhibition displays; and

3. identify ways in which traveling exhibitions help host institutions serve their audience and community members.

DESCRIPTION OF RESPONDENTS: The Exhibition Program maintains a list of host institution contacts for all traveling exhibition bookings. Those contacts make up the pool of possible respondents to the survey. Annually, there are more than 150 traveling exhibition bookings, for which hosting institutions will receive the online survey request.

TYPE OF COLLECTION: (Check one)

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

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

[] Focus Group [X] Other: Online survey instrument using SurveyMonkey.

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.

Name: Jiwon Kim, Exhibition Program/HMD/LO/NLM_

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

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 [X] N/A

Gifts or Payments:

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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per response (in hours)	Total Burden Hours
Individuals and Households	350	1	20/60	117 hrs.
Totals	350	350		117 hrs.

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Individuals	117 hrs.	$27.94	$3,268.98
Totals			$3,268.98

BLS National Occupational Employment and Wage Estimate of median hourly wage for librarians: http://www.bls.gov/oes/current/oes254021.htm

FEDERAL COST: The estimated annual cost to the Federal government is: $1,600.

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Coast to Gov’t
Federal Oversight
Lead Exhibit Specialist	13/04	$99,905	0.025%	-	$24.98
Contractor Cost
Coordinator	-	$72,800	0.84%	-	$611.52
Total					$636.50

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?

[X] Yes [] 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?

The Exhibition Program maintains a list of host institution contacts for all traveling exhibition bookings. Those contacts make up the pool of possible respondents to the survey. The Exhibition Program sends an email solicitation with the link to the online survey to each host contact a day or so after the exhibition’s closing date. In addition, a follow-up email is sent to remind those host institutions that have not completed the online survey in 15-16 days after the closing date.

Administration of the Instrument

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

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

[ ] Telephone The Exhibition Program will conduct a follow-up phone call in order to confirm receipt of the email and the form by the past host institutions.

[ ] In-person

[ ] Mail

[] Other, Explain.

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

Please make sure that all instruments, instructions and scripts are submitted with the request.

Attachment #1 – NLM HMD Traveling Exhibition Host Survey instrument [screen-shots of the online survey]

Attachment #2 - NLM HMD Traveling Exhibition Email Solicitation [two scripts for an initial survey request & a follow-up emails]

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