OMB #: 1850-0800 Expiration
Date: 4/12/08
Evaluation of the DC Opportunity Scholarship Program
Elementary (Grades 4-5)
Student Questionnaire
Spring 2008
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 1850-0800 (expiration date: 4/12/08). The time
required to complete this information collection is estimated to
average 1/4 hour, including the time to review instructions, search
existing data resources, gather the data needed, and complete the
information collection. If
you have any comments concerning the accuracy of the time estimate
or suggestions for improving this form, please contact:
Marsha Silverberg, U.S. Department of Education, Institute of
Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208,
marsha.Silverberg@ed.gov. If
you have comments or concerns regarding the status of your
individual submission of this form, e-mail directly to:
babettegutmann@westat.com. Responses
to this data collection will be used only for statistical purposes.
The reports prepared for this study will summarize findings across
the sample and will not associate responses with a specific district
or individual. We will not provide information that identifies you
or your district to anyone outside the study team, except as
required by law.
Please answer all the questions.
Part 1: About You
This first section asks about you.
Q1. Are you a ….
Boy 1
Girl? 2
Q2. How many people are living in your home, including you? _______________
Q3. Do you speak English at home?
( Check one)
Yes 1
No 2
Q4. Starting with first grade, how many schools have you gone to?
( Check one)
One school 1
Two schools 2
Three schools 3
Four or more schools 4
Q5. Do you mostly agree or mostly disagree with the comments below about yourself?
( Check one box on each row)
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Mostly |
Mostly disagree |
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1 |
2 |
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1 |
2 |
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Q6. How often do you read for fun?
( Check one)
Every day 1
Most days 2
Some days 3
Never 4
Q7. How far do you expect to go in school?
( Check one)
Some high school, but will not finish 1
Will finish high school 2
Some college, but will not finish 3
Will finish a 2 year college 4
Will finish a 4 year college 5
Will go to more school after college 6
Q8. Have you done any of these things this year?
( Check yes or no on each row)
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Yes |
No |
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1 |
2 |
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1 |
2 |
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1 |
2 |
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1 |
2 |
Took classes in: |
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1 |
2 |
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1 |
2 |
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1 |
2 |
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1 |
2 |
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1 |
2 |
Q9. On a regular school day, how long are you at home after school with no adult there?
( Check one)
Never, hardly ever 1
Less than 1 hour 2
1-2 hours 3
2-3 hours 3
More than 3 hours 4
Q10. How often do you talk to adults in your family about:
( Check one box on each row)
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Often |
Sometimes |
Rarely |
Never |
Good things at school |
1 |
2 |
3 |
4 |
Problems you face at school |
1 |
2 |
3 |
4 |
Other topics that interest you |
1 |
2 |
3 |
4 |
Q11. How many of your friends do your parents know by name?
( Check one)
All of them 1
Most of them 2
Some of them 3
None of them 4
Part 2: About Your School
This section asks about your school and your school experiences.
Q12. Do you agree or disagree with these statements about your school?
( Check one box on each row)
|
Agree strongly |
Agree |
Disagree |
Disagree strongly |
Students are proud to go to this school |
1 |
2 |
3 |
4 |
Students learn a lot at the school |
1 |
2 |
3 |
4 |
Rules about behavior are strict |
1 |
2 |
3 |
4 |
When students misbehave, they receive the same treatment |
1 |
2 |
3 |
4 |
I don’t feel safe |
1 |
2 |
3 |
4 |
People at my school support me |
1 |
2 |
3 |
4 |
I feel lonely at my school |
1 |
2 |
3 |
4 |
I enjoy going to school |
1 |
2 |
3 |
4 |
Q13. What overall grade would you give your school?
( Check one)
A-Excellent 1
B-Good 2
C-Fair 3
D-Unsatisfactory 4
F-Failing 5
Q14. Do you agree or disagree with these statements about the students and teachers in your school?
( Check one box on each row)
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Agree strongly |
Agree |
Disagree |
Disagree strongly |
Students |
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Teachers |
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1 |
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3 |
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Q15. Did the following ever happen to you at school this year?
( Check one box on each row)
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Never |
Once or twice |
3 times or more |
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1 |
2 |
3 |
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1 |
2 |
3 |
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2 |
3 |
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Q16. How many times during the last two weeks were you:
( Check one box on each row)
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Never |
1 or 2 times |
3 or 4 times |
5 or more times |
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1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
Part 3: About Your Classes
This next section asks questions about the classes you are taking at school.
Q17. Do you agree or disagree with these statements about your classes this year?
( Check one box on each row)
|
Agree strongly |
Agree |
Disagree |
Disagree strongly |
Class work was hard to learn |
1 |
2 |
3 |
4 |
I had trouble keeping up with the homework |
1 |
2 |
3 |
4 |
I need more help from my teachers than I get |
1 |
2 |
3 |
4 |
I understand what teachers explain in my class |
1 |
2 |
3 |
4 |
Teachers encourage me to do my best |
1 |
2 |
3 |
4 |
Q18. How many nights per week do you usually do homework?
( Check one)
Zero nights per week 0 Go to Question 20
1 night per week 1
2 nights per week 2
3 nights per week 3
4 nights per week 4
5 nights per week 5
Q19. How many minutes do you usually spend doing homework per day?
___________ (minutes)
Q20. During the past month, how often did your parents help you with your homework?
( Check one)
Never 1
Once 2
2-3 times 3
4-5 times 4
6 or more times 4
Part 5: About Private School Scholarships
This last section asks if you had a chance to attend a private school for free.
Q21. Did you receive a scholarship to go to a private school this year?
( Check one)
Yes 1 Go to Question 22
No 2 STOP – please hand in your survey
I Don’t Know 3 STOP – please hand in your survey
Q22. Were you involved in deciding whether to go to a private school?
( Check one)
Yes 1
No 2
Q23. Are you now going to a private school using the scholarship you were offered?
( Check one)
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1 |
STOP – please hand in your survey |
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2 |
Go to Question 24 on the next page |
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3 |
Go to Question 25 on the next page |
Q24. If you were offered a scholarship to attend a private school but decided not to use it, why?
( Check all that apply)
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STOP – please hand in your survey
Q25. If you used the scholarship to attend a private school but left that school during the year, why?
( Check all that apply)
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Thank you, please hand in your survey.
File Type | application/msword |
Author | Mike Puma |
Last Modified By | Roseta.Hall |
File Modified | 2007-12-12 |
File Created | 2007-12-12 |