Teacher Survey

Appendix A.1

SIXTH GRADE TEACHER SURVEY (2007-08)
NATIONAL EVALUATION OF READING COMPREHENSION PROGRAMS
U.S. DEPARTMENT OF EDUCATION

ATTACH LABEL HERE
Teacher ID Teacher Name
School ID School Name
IF ABOVE INFORMATION IS INCORRECT,
PLEASE MAKE CORRECTIONS DIRECTLY ON LABEL.

This survey is part of the Evaluation of Reading Comprehension Programs, a national
evaluation being conducted for the U.S. Department of Education. The questions ask
about the professional culture at your school, your reflections, and your background. All
information you provide will be kept confidential. While you are not required to respond,
your cooperation is needed to make the results of this survey comprehensive and
accurate. Thank you.

Please return the completed form to:
Mathematica Policy Research, Inc.
315 Enterprise Drive
Plainsboro, NJ 08536
ATTN: Ms. Season Bedell-Boyle

If you have questions, please contact:
Ms. Valerie Williams
Phone: 888.535.0283
FAX: 202.863.1763
E-mail: VWilliams@mathematica-MPR.com

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this
information collection is 1850-0812. The time required to complete this information collection is estimated
to average 20 minutes per response, including the time to review instructions, search existing data
resources, gather the data needed, and complete and review the information collected. If you have any
comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please
write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have comments or
concerns regarding the status of your individual submission of this form, write directly to: U.S.
Department of Education, Institute for Education Sciences, Washington, D.C. 20208-5651.
OMB NO.: 1850-0812
EXPIRATION DATE: 03/31/2009

Appendix A.1 (continued)

1. How many years have you taught, either full-time or part-time, at the elementary or secondary
level (not counting the current school year)? Include years teaching in both public and private
schools. Do not include time spent as a student teacher.
.$$$$.$$$$. TOTAL YEARS TEACHING

2. How many years have you been teaching in THIS school (not counting the current school
year)? If you have had a break in service of one year or more, please report the year that you
returned to this school. Do not include time spent as a student teacher. Include years spent teaching
both full- and part-time at this school.
.$$$$.$$$$. TOTAL YEARS TEACHING AT THIS SCHOOL

3. What grade levels have you taught? CHECK ALL THAT APPLY
1 c 1st grade
6 c 6th grade
11 c 11th grade
2 c 2nd grade
7 c 7th grade
12 c 12th grade
3 c 3rd grade
8 c 8th grade
13 c Ungraded
4 c 4th grade
9 c 9th grade
14 c Kindergarten
5 c 5th grade
10 c 10th grade
15 c Prekindergarten
4. Column A: For each degree below, please check YES or NO to indicate if you hold that degree.
Columns B and C: For those degrees you hold, please specify your major field of study and
the year you received the degree.
IN EACH ROW, CHECK ONE BOX IN COLUMN A.
IF YOU ANSWER YES IN COLUMN A, COMPLETE
COLUMNS B AND C FOR THAT ROW..

A. DEGREE
HELD
YES

NO

B. MAJOR

C. YEAR
RECEIVED

a. Associate’s degree.....................................

1

c

0

c

.$$.$$.$$.$$.

b. Bachelor’s degree ......................................

1

c

0

c

.$$.$$.$$.$$.

c. Master’s degree .........................................

1

c

0

c

.$$.$$.$$.$$.

d. Educational specialist or professional
diploma (at least one year beyond a
master’s degree) ........................................

1

c

0

c

.$$.$$.$$.$$.

e. Certificate of Advanced Graduate Studies ..

1

c

0

c

.$$.$$.$$.$$.

1

c

0

c

.$$.$$.$$.$$.

1

c

0

c

.$$.$$.$$.$$.

f. Doctorate (Ph.D., Ed.D.).............................
g. Professional (M.D., D.D.S., J.D., L.L.B) ......

Prepared by Mathematica Policy Research

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Sixth Grade Teacher Survey 2007-08

Appendix A.1 (continued)

5. Which of the following describes the teaching certificate you currently hold in this state?
CHECK ONE ONLY
1c

Regular or standard state certificate or advanced professional certificate

2c

Probationary certificate (the initial certificate issued after satisfying all requirements except the
completion of a probationary period)

3c

Provisional or other type given to persons who are still participating in an “alternative
certification program”

4c

Temporary certificate (requires some additional college coursework and/or student teaching
before regular certification can be obtained)

5c

Emergency certificate or waiver (issued to teachers who do not have regular certification who
need to complete a regular certification program in order to continue teaching)

6. In what content area does the teaching certificate marked above allow you to teach in this
state (e.g., elementary general, secondary general, special ed., a specific subject matter)?
CONTENT AREA

7. Column A: Please indicate if you participated in any professional development activities
listed below in the past 12 months.
Column B: If you mark “yes” in Column A, please indicate in Column B how many hours you
spent on the activities. Include courses you have taken for recertification or advanced certification,
workshops sponsored by your district, conferences, or other training that is relevant to your teaching.

IN EACH ROW, CHECK ONE BOX IN COLUMN A.
IF YOU ANSWER YES, CHECK ONE BOX IN
COLUMN B.

A. PARTICIPATED?
YES

NO

B. NUMBER OF HOURS
8 OR
FEWER

9-16

17-32

33 OR
MORE

a. Reading instruction..............................

1

c

0

c

1

c

2

c

3

c

4

c

b. Science instruction ..............................

1

c

0

c

1

c

2

c

3

c

4

c

c. Social studies instruction .....................

1

c

0

c

1

c

2

c

3

c

4

c

Prepared by Mathematica Policy Research

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Sixth Grade Teacher Survey 2007-08

Appendix A.1 (continued)

8. Are you male or female?
1c

Male

2c

Female

9. Are you of Hispanic or Latino origin?
1 cYes
0c

No

10. How do you describe yourself? (PLEASE SELECT ONE OR MORE)
1c

American Indian or Alaska Native

2c

Asian

3c

Black or African American

4c

Native Hawaiian or Other Pacific Islander

5c

White

11. What is your year of birth?
.$$$$.$$$$.$$$$.$$$$. YEAR

CONTACT INFORMATION
Please provide your contact information and the best time to reach you in case we have questions about
your responses.
MR./MS.

FIRST NAME

LAST NAME

STREET

APT. NUMBER

CITY

STATE

ZIP

E-MAIL ADDRESS
(
)
PHONE NUMBER (INCLUDE AREA CODE)
BEST TIME TO REACH YOU

THANK YOU FOR COMPLETING THIS SURVEY
FOR THE U.S. DEPARTMENT OF EDUCATION.

Prepared by Mathematica Policy Research

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Sixth Grade Teacher Survey 2007-08