National Study to Inform the 21st Century Community Learning Centers (CCLC) Program

Documents and Forms

Document Name Document Type
APPENDIX B_Afterschool Center Coaching Log.docx Other-Afterschool Center Director/St
APPENDIX B_Afterschool Center Coaching Log.docx Other-Afterschool Center Director/St
APPENDIX C_Request for Student Afterschool Attendance Records.docx Other-Afterschool Center Student Att
APPENDIX C_Request for Student Afterschool Attendance Records.docx Other-Afterschool Center Student Att
APPENDIX D_Parent or Guardian Questionnaire_redacted.docx Other-Parent/Guardian Questionnaire
APPENDIX D_Parent or Guardian Questionnaire_redacted.docx Other-Parent/Guardian Questionnaire
APPENDIX E_Parent or Guardian Permission Form 4 27 2021.docx Other-Parent/Guardian Permission For
APPENDIX E_Parent or Guardian Permission Form 4 27 2021.docx Other-Parent/Guardian Permission For

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Study to Inform the 21st Century Community Learning Centers (CCLC) Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Afterschool Center Director/Staff Coaching Log	APPENDIX B_Afterschool Center Coaching Log.docx	Yes	Yes	Fillable Fileable
Other-Afterschool Center Student Attendance Records Request	APPENDIX C_Request for Student Afterschool Attendance Records.docx	Yes	Yes	Fillable Fileable
Other-Parent/Guardian Questionnaire	APPENDIX D_Parent or Guardian Questionnaire_redacted.docx	Yes	Yes	Fillable Fileable
Other-Parent/Guardian Permission Form	APPENDIX E_Parent or Guardian Permission Form 4 27 2021.docx	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: 1,228	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,228	1,228
Annual IC Time Burden (Hours)	397	397
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.