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Participant Baseline Survey and Consent Form
Strengthening Community Colleges Training Grants Program Round 4 (SCC4) Evaluation
OMB:
IC ID: 276094
OMB.report
OS
ICR 202507-1290-001
IC 276094
( )
Documents and Forms
Document Name
Document Type
T2-2025-06 SCC4_Appendix B. Participant baseline survey and consent form_Spa_6-11 to DOL 7.11.25.docx
www.SCCNationalEval.com/Baseline
Other-Survey
T2-2025-06 SCC4_Appendix A. Participant baseline survey and consent form_Eng_6-11 to DOL 7.11.25 Clean.docx
www.SCCNationalEval.com/Baseline
Other-Survey
T2-2025-06 SCC4_Appendix C. Participant Study Intake Staff FAQ_6-11 to DOL 7.11.25.docx
Participant Study Intake Staff FAQ
IC Document
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Eng_6-11 to DOL 7.11.25.docx
Participant random assignment notification_Eng_6-11
IC Document
T2-2025-06 SCC4_Appendix P. Participant random assignment notification_Spa_6-11 to DOL 7.11.25.docx
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Spa_6-11
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participant Baseline Survey and Consent Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
Other-Survey
T2-2025-06 SCC4_Appendix B. Participant baseline survey and consent form_Spa_6-11 to DOL 7.11.25.docx
https://www.SCCNationalEval.com/Baseline
Yes
Yes
Fillable Fileable
Other-Survey
T2-2025-06 SCC4_Appendix A. Participant baseline survey and consent form_Eng_6-11 to DOL 7.11.25 Clean.docx
https://www.SCCNationalEval.com/Baseline
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
6,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
6,000
0
6,000
0
0
0
Annual IC Time Burden (Hours)
1,500
0
1,500
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Participant Study Intake Staff FAQ
T2-2025-06 SCC4_Appendix C. Participant Study Intake Staff FAQ_6-11 to DOL 7.11.25.docx
07/16/2025
Participant random assignment notification_Eng_6-11
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Eng_6-11 to DOL 7.11.25.docx
07/16/2025
T2-2025-06 SCC4_Appendix O. Participant random assignment notification_Spa_6-11
T2-2025-06 SCC4_Appendix P. Participant random assignment notification_Spa_6-11 to DOL 7.11.25.docx
07/16/2025
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.