SURVEY NUMBER SV-2001-0013-A  |  OMB NUMBER 1405-0018  |   Estimated Completion Time 20 MINUTES
U.S. Department of State | Bureau of Educational and Cultural Affairs
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please send email to:
speakout@state.gov

Hello! Have you ever participated in or administered an exchange visitor or any similar program sponsored by the United States Department of State or, before October l999, the United States Information Agency (USIA), including U.S. embassies abroad? If so, we're interested in hearing from you. Many of you have first-hand experience or knowledge of how international exchange participants have shared their U.S. experiences and understanding of U.S. society and policies with others. We at the Bureau of Educational and Cultural Affairs, therefore, invite our exchange program participants, colleagues working for grantee organizations, affiliated NGOs, U.S. Embassy staff, programming agencies, volunteers and other interested parties to describe how our current and former program participants share their U.S. experience and understanding of U.S. society and policies, and what personal or institutional linkages may have been built as result of those experiences. This information will help us assess the "real-world" impact of international exchanges.

To be able to utilize your comments effectively, we have created a repository to capture the impact these programs have had on others. Please click the link below to be taken to a short questionnaire. Please note that submissions will be included in an open-access repository and available to the general public and therefore should not be considered confidential.


Paperwork Reduction Act Statement

Public reporting burden for this collection of information is estimated to average twenty (20) minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Responses to this package are voluntary. An Agency may not conduct or sponsor, and the respondent is not required to respond to, a collection of information unless it displays a valid OMB control number. The U.S. Department of State regularly monitors its international exchange programs, gathers data about program accomplishments, and evaluates selected ones. The information gathered is used by the U.S. Department of State's Bureau of Educational and Cultural Affairs (ECA) to inform program design, management, and funding. The information collection activity involved with the program is conducted pursuant to the mandate given to the U.S. Department of State under the terms and conditions of the Mutual Educational and Cultural Exchange Act of 1961, P.L. 87-256. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: A/RPS/DIR, U.S. Department of State, Washington, D.C. 20520.


Privacy Act Statement
Bureau of Educational and Cultural Affairs Evaluation Projects

Authorities:
The information solicited on this form is requested pursuant to provisions in the Mutual Educational and Cultural Exchange Act of 1961, Public Law 87-256, as amended, also known as the Fulbright-Hays Act.

Purpose:
The primary purpose for soliciting the information is to assess the effectiveness and impact of an international educational and cultural exchange program administered by the Bureau of Educational and Cultural Affairs in the U.S. Department of State on individual participants to determine if the program is meeting its goals and legislative mandate. Personal data collected under this solicitation will be used only by authorized State Department program managers for the sole purpose of program follow-up or enhancement.

Routine Uses:
The information solicited on this form is made available as a routine use to appropriate agencies, whether federal, state, local or foreign, for law enforcement and administration purposes. The information may also be made available to foreign governments and non-governmental organizations in vetting the process and selection of participants and to peer review committees of cooperating agencies for the ranking and rating process.

The submission of this information is voluntary. However, if incomplete information is provided, authorized officials may be unable to report accurately on the results of the exchange program. There is no effect to the individual for failure to provide the solicited information.