One Pager Justification

Request for Approval under the “Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery” (OMB Control Number: 0704-0553)

TITLE OF INFORMATION COLLECTION:

Camp Butler Youth Sports Program Surveys

PURPOSE:

The intended purpose of this effort is to gauge our support and inclusion of children with special needs, as well as overall customer satisfaction with the Youth Sports Programs at Camp Butler to determine areas in need of improvement.

DESCRIPTION OF RESPONDENTS:

Surveys will be distributed to parents of children in the Youth Sports and Learn to Swim Programs aboard Marine Corps Base Camp Butler in Okinawa, Japan. Customers may include active-duty personnel, family members, civilians, contractors, and retirees. Customers may be members of any military branch (i.e., USMC, USAF, USA, USN) but they are not specifically targeted.

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: Paul K. Honnold

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

3. If Yes, has an up-to-date System of Records Notice (SORN) 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
Individuals or Households (Youth Sports Program Survey)	272	5 minutes	22.67 hours
Individuals or Households (Learn to Swim Program Survey)	89	5 minutes	7.42 hours
Totals	361		30 hours

PUBLIC COST: The estimated annual cost to the public is $451.00

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?

We have a customer list and intend to distribute surveys to all customers. We average 550 customers per youth sports season and 200 customers per learn to swim season. Customers will be contacted via email, and we expect a response rate between 5% and 30%.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[X] Other, Explain: Direct email fillable PDF form

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

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