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pdfAppendix C. NHES-FS Topical Surveys
C.1 Adult Training and Education Survey (ATES) for national sample
C.2 Credentials for Work Survey (CWS) for national sample
C.3 ATES for seeded sample
C.4 CWS for seeded sample
C.5 After-School Programs and Activities Survey (ASPA) version A
C.6 ASPA version B
C.1 Adult Training and Education Survey (ATES) for national sample
OMB No. 1850-0803: Approval Expires 09/30/2016
Adult Training and Education Survey
Part of the 2014 National Household Education Survey
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
2
Instructions
In response to the survey you answered earlier, we recorded that the
person listed below is between the ages of 16 to 65, is no longer in high
school, and lives in this household. If this information is not correct,
please call us at the toll-free number below so we can be sure you
received the correct survey.
These questions should be filled out by:
No one else in the household should fill out the survey.
To answer a question, simply mark the box [X] that best represents your
answer.
Use a black or blue pen, if available, to complete this survey.
Please return the completed survey using the postage-paid envelope
provided.
If you have any questions about this survey, please call us at our tollfree number: 1-888-xxx-xxxx.
We are authorized to collect this information by U.S. Code, Title 20, Section 9543. You do not have to provide
the information requested. However, the information you provide will help the Department of Education’s
ongoing efforts to learn more about the educational experiences of adults. There are no penalties should you
choose not to participate in this study. Your answers may be used only for statistical purposes and may not be
disclosed, or used, in identifiable form for any other purpose except as required by law (U.S. Code, Title 20,
Section 9573). Your responses will be combined with those from other participants to produce summary
statistics and reports.
Depending on your background, this survey is estimated to take 10 to 20 minutes, including time for reviewing
instructions and completing the survey. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: Lisa Hudson, National Center for Education Statistics, U.S.
Department of Education, 1990 K Street NW, Washington, DC 20006-5650. Do not return the completed form
to this address.
3
Educational Attainment
Certification and Licensure
1. What is the highest degree or level of school
you have completed? (Mark one.)
3. Do you have a currently active professional
certification or a state or industry license? Do
not include business licenses, such as a liquor
license or vending license.
□ Elementary or high school,
but no high school diploma or GED GO TO
question 3.
□ High school diploma
□ GED, or alternative credential
□ Some college credit but less
than one year of college credit
A professional certification or license shows you
are qualified to perform a specific job and includes
things like Licensed Realtor, Certified Medical
Assistant, Certified Construction Manager, or an IT
certification.
□ No
□ 1 or more years of college credit,
no degree
GO TO question 10 on page 10.
□ Yes
□ Associate’s degree (for example, AA, AS)
□ Bachelor’s degree (for example, BA, BS)
4. How many certifications and licenses do
you have?
□ Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)
If you had to get a certification in order to
get a license, count each certification and
license separately.
□ Professional degree beyond a bachelor’s
degree (for example, MD, DDS, DVM, LLB,
JD)
Number of certifications and licenses:
□ Doctorate degree (for example, PhD, EdD)
CONTINUE on page 6.
2. Using Table A on page 5, what was the major
or field of study for your highest level of
education?
If there was more than one, please choose the
one you consider most important.
Number from Table A on page 5:
4
TABLE A. FIELD OF STUDY CODES FOR QUESTION 2
1
Accounting, finance, insurance, or real
estate
21 Law enforcement, security, or
firefighting
2
Administrative support
22 Journalism or communications
3
Agriculture
23 Law or legal studies
4
Architecture
24 Leisure or fitness studies
5
Arts, music, or design
25 Liberal arts
6
Biological/biomedical sciences
26 Library science
7
8
Business management or marketing
Communications technologies (e.g.,
printing, broadcasting, recording, and
graphics technologies)
27 Manufacturing or production (e.g.,
machinist, welder, boilermaker)
9
28 Mathematics or statistics
29 Mechanic or repair technologies
Computer and information sciences
30 Military science/technologies
10 Construction trades
31 Natural resources or conservation
11 Cosmetology or barbering
32 Philosophy or comparative religions
12 Culinary arts
33 Physical sciences
13 Drafting, engineering technologies, or
science technologies
34 Psychology
35 Religious vocations or theology
14 Education
36 Social or human services or public
administration
15 Engineering
16 English language/literature
37 Social sciences (e.g., anthropology,
gender or ethnic studies) or history
17 Family and consumer sciences
18 Foreign languages
38 Transportation or materials moving
39 Interdisciplinary
19 Funeral/mortuary services
20 Healthcare professions
5
5. Please fill out a column in the following grid for each currently active certification and license you have,
up to three.
If you have more than three, answer for the three you last earned or renewed.
Certification or License
#1
Certification or License
#2
Certification or License
#3
5a. In your own words, what is
the name of the
certification or license?
5b. Using Table B on page 7,
what is its subject field?
Number
from Table B:
Number
from Table B:
Number
from Table B:
5c. Could you use it to get a
job with another employer
in that field?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
□ I don’t know
□ I don’t know
□ I don’t know
5d. Did you have to pass a test,
submit a portfolio, or
demonstrate your skills to
get it?
□ No
□ Yes
□ No
□ Yes
□ No
□ Yes
5e. Was it awarded by the
federal, state, or local
government?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
□ I don’t know
□ I don’t know
□ I don’t know
□ No
□ No
□ No
□ Yes, and it is
□ Yes, and it is
□ Yes, and it is
required
required
required
(For example, by a state
board of education or other
state board, OSHA, or FAA)
5f. Is it for your current job?
(Mark one.)
□ Yes, but it is not
□ Yes, but it is not
required
5g. In what year did you last
earn or renew it?
□ Yes, but it is not
required
Year:
Year:
6
required
Year:
TABLE B. FIELD OF CERTIFICATION OR LICENSE CODES FOR QUESTION 5b
1
EMT, CPR, or basic first aid
11 Law or legal support
2
Other health care (for fitness use code 13)
Includes health-care technologist or
technician; health-care therapist (for
counseling use code 17); nursing
occupations, medical practitioners (such as
MD, OD, PA, DC, PharmD, DVM), and healthcare specialties such as ACLS.
12 Notary public
3
Architecture, engineering, or energy
Includes architecture, drafting, engineering,
engineering technologies, LEED, energy
auditing and other similar fields.
4
Business management, operations, and
support
Includes project management, Six Sigma,
Lean Manufacturing, and other business
management, support, and operations.
5
Childcare
6
Cosmetology or barbering
7
Finance, insurance, or real estate
Includes insurance, real estate, taxes
and accounting, and other finance (for
notary public use code 12).
8
9
13 Physical fitness
Includes personal or athletic trainer,
yoga instructor, and other fitness
instruction.
14 Public safety
Includes law enforcement, firefighting,
flight attendant, and other public safety
services (for water and hazardous waste
treatment use code 8).
15 Religious ordination
16 Skilled trades
Includes automotive repair, HVAC
installation and repair, construction trades
(carpenter, electrician, mason, plumber),
welder, and machining or equipment
operator (such as boiler, crane, or forklift
operator).
17 Social work or counseling
18 Teaching (public or private schools)
Includes preschool through grade 12
teaching. (For other instructional fields, use
the code for that field; for example, flight
instructors use code 19 for transportation.)
Food handling and sanitation
Includes food handling, water treatment and
sanitation, hazardous waste operations, and
other food handling and sanitation fields.
19 Transportation
Includes CDL, aviation or marine piloting,
and other transportation work (for flight
attendant use code 14).
Funeral, mortuary, and taxidermy
10 Information technology
Includes software development and
applications, networking, hardware, and
other computer and information
technologies.
20 Other fields not listed above
7
The rest of this section asks about the
certification or license you last earned or
renewed – that is, the one with the most
recent year in question 5g on page 6.
7. Which of the following prepared you to earn this
certification or license? (Mark ALL that apply.)
□ I earned a college degree.
□ I took other classes from a college,
6. How useful has your last certification or
license been for each of the following?
□
a. Getting a job. (Mark one.)
□
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
technical school, or trade school.
I took classes or training from a company,
association, union, or private instructor.
I studied on my own using textbooks or
on-line resources.
I participated in on-the-job training, an
internship, or apprenticeship.
I did not take any classes, training, or
instruction.
b. Keeping a job. (Mark one.)
□
□
□
□
8. How often do you have to renew this
certification or license? (Mark one.)
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
□
□
□
□
c. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□ Renew it
□ Let it expire
□ I don’t know
Too soon to tell
Not useful
Somewhat useful
Very useful
CONTINUE on page 10.
e. Improving your job skills. (Mark one.)
□
□
□
□
GO TO
question 10
on page 10.
9. What do you plan to do the next time this
certification or license is up for renewal? (Mark
one.)
d. Keeping you marketable to employers or
clients. (Mark one.)
□
□
□
□
I do not have to renew it
Once a year
Every 2 years
Every 3 years
Every 4 years
Every 5 or more years
Too soon to tell
Not useful
Somewhat useful
Very useful
8
This page left blank intentionally.
9
14. Did you get this educational certificate in order
to earn a professional certification or license?
Educational Certificates
□ No
10. After leaving high school, some people take
classes at a college, technical school, or trade
school to earn an educational certificate.
□ Yes
This educational certificate is sometimes called a
diploma, for example a cosmetology diploma.
But it is not a high school diploma. It is also not a
college degree or a professional certification.
15. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
An educational certificate is awarded only by
schools.
□ Not at all
□ Somewhat
□ A great deal
Have you ever earned this type of educational
certificate?
□
No
□
Yes
16. What type of school awarded this educational
certificate? (Mark one.)
GO TO question 26 on page 13.
□ Trade or vocational school; community
or technical college
The next few questions ask about your last
educational certificate.
□ Other college or university
□ Other type of school (specify)
11. About how many hours of instruction did you
complete in order to earn your last educational
certificate? (Mark one.)
□ 160 or more hours (4 or more full-time
17. Was this educational certificate earned as part
of a bachelor’s or master’s degree, or as an
add-on to a degree?
weeks)
□ 40-159 hours (1 week to less than four
full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
□ No
□ Yes
12. Using Table C on page 11, what was the field of
study for this educational certificate?
18. Do you have another educational certificate?
Number from Table C:
□
No
□
Yes
CONTINUE
ON page 12.
13. In what year did you get this educational
certificate?
Year:
10
GO TO question 26 on page 13.
TABLE C. FIELD OF STUDY CODES FOR QUESTIONS 12 AND 20
1
2
3
4
5
6
7
8
9
Accounting, finance, insurance, or
real estate
Administrative support
Arts, music, or design
Business management or
marketing
Communications technologies (e.g.
printing, broadcasting, recording,
and graphics technologies)
Computer and information sciences
Construction trades
Cosmetology or barbering
Culinary arts
10
11
12
13
14
15
16
17
18
19
20
11
Drafting, engineering technologies, or
science technologies
Education
Funeral/mortuary services
Healthcare professions
Law enforcement, security, or firefighting
Legal studies
Manufacturing or production (e.g.,
machinist, welder, boilermaker)
Mechanic or repair technologies
Religious vocations or theology
Transportation or materials moving
Other field of study not listed above
The next few questions ask about your next-to-last
educational certificate.
24. What type of school awarded this certificate?
(Mark one.)
19. Thinking about your next-to-last educational
certificate, about how many hours of
instruction did you complete in order to earn
it? (Mark one.)
□ Trade or vocational school; community or
technical college
□ Other college or university
□ Other type of school (specify)
□ 160 or more hours (4 or more full-time
weeks)
□ 40-159 hours (1 full-time week to less
than four full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
25. Was this certificate earned as part of a
bachelor’s or master’s degree, or as an add-on
to a degree?
□ No
20. Using Table C on page 11, what was the field of
study for this educational certificate?
□ Yes
Number from Table C:
21. In what year did you get this educational
certificate?
Year:
22. Did you get this educational certificate in order
to earn a professional certification or license?
□ No
□ Yes
23. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
□ Not at all
□ Somewhat
□ A great deal
12
30. As part of this apprenticeship, did you take any
formal classes? Include any classes taken inperson or on-line. (Mark all that apply.)
Apprenticeships
26. Have you ever completed an apprenticeship?
□ No
□ Yes, from an employer or union
□ Yes, from a community or technical college
Do not count student teaching, medical
internships or residency, externships, or unpaid
internships.
□
No
□
Yes
or other college
□ Yes, from another organization
GO TO question 36 on page 14.
31. What wage did you earn during this
apprenticeship program? (Mark one.)
The rest of this section asks about the last
apprenticeship you completed.
□ No wage
□ A low starting wage that increased as I
27. Who sponsored the apprenticeship? (Mark
one.)
□
□
□
□
□
□
□
became more qualified during the
apprenticeship
□ A low starting wage that increased only
when I became fully qualified at the end of
the apprenticeship
□ The same wage as a fully qualified worker
The U.S. military
Federal civilian government
State or local government
A (non-military) employer
An employer-union partnership
Other sponsor
I don’t know
32. What type of occupation was this
apprenticeship for? (Mark one.)
□
□
□
□
□
□
□
□
□
□
□
□
□
28. Did this apprenticeship lead to a Certificate of
Completion of Apprenticeship from your state
or from the U.S. government?
□
□
□
No
Yes
I don’t know
29. How long did this apprenticeship last? (Mark
one.)
□
□
□
□
□
Less than 1 year
1 year
2 years
3 years
4 years or more
13
Construction trades
Driving or transport
Engineering or architecture
Food preparation
Health care
Information technology (IT)
Management
Manufacturing, printing, or production
Mechanic, installation, or repair
Public safety or corrections
Real estate, finance, or insurance
Other sales or customer service
Other (specify)
33. How useful was your apprenticeship for each of
the following?
College and Other Classes
a. Getting a job. (Mark one.)
□
□
□
□
36. Since leaving high school, have you taken any
of the following types of classes?
Too soon to tell
Not useful
Somewhat useful
Very useful
a. Classes to learn English as a second
language (ESL). (Mark all that apply.)
□
□
□
b. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
b. Classes to prepare for the General
Educational Development (GED) test, or
some other high school equivalency
program. (Mark all that apply.)
c. Improving your job skills. (Mark one.)
□
□
□
□
No
Yes, took over 12 months ago
Yes, took within past 12 months
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
No
Yes, took over 12 months ago
Yes, took within past 12 months
c. Literacy classes to help adults read better.
Do not include college classes. (Mark all
that apply.)
34. Are you currently working in the occupation
that you apprenticed in?
□ No
□ No
□ Yes
□
□
Yes, took over 12 months ago
Yes, took within past 12 months
37. How many college classes have you taken in
the past 12 months?
35. In your current job, how often do you use the
skills that you learned in your apprenticeship?
If you are not employed, please answer “Never
or almost never”.
Count only classes you completed or are
currently taking.
□ Never or almost never
□ Sometimes
□ All or most of the time
□ I have not taken any
college classes in the
past 12 months.
GO TO question
45 on page 17.
Number of college classes:
CONTINUE WITH
question 38.
14
38. How many of these classes were not for college
credit (that is, non-credit)?
41. How useful was this class for each of the
following?
Count only classes you completed within the
past 12 months or are currently taking.
□
□
□
□
□
I don’t know
None
One
Two
Three or more
a. Increasing your pay. (Mark one.)
□
□
□
□
GO TO question 45 on
page 17.
Too soon to tell
Not useful
Somewhat useful
Very useful
b. Keeping you marketable to employers
or clients. (Mark one.)
The rest of this section asks about the last noncredit class you took.
□
□
□
□
If you took more than one non-credit class during
the same time period, please answer the questions
for the class you took earlier in the week or if on the
same day, earlier in the day.
Too soon to tell
Not useful
Somewhat useful
Very useful
c. Improving your work skills. (Mark one.)
□
□
□
□
39. What was the primary subject or field of study
for your last non-credit class?
Too soon to tell
Not useful
Somewhat useful
Very useful
42. Were you employed when you took this class?
(Mark one.)
40. Which of the following describe why you took
this class? (Mark all that apply.)
□
□
□
□ To prepare for or to consider further
□
□
□
□
education
For personal interest
To earn, maintain, or renew a
professional certification or license
For my current job
For another work-related reason
GO TO
No
question 45
on page 17.
Yes, I was self-employed.
Yes, I was employed by someone else.
43. Was this class required by your employer?
□
□
No
Yes
44. Did your employer pay for this class? Include
reimbursements from your employer. (Mark
one.)
□
□
□
15
No
Yes, partly
Yes, completely
This page left blank intentionally.
16
Training for Work
45. People often participate in courses, training, or
other instruction for work.
These trainings can include classes, seminars, or
workshops. They can be taken at the workplace,
on-line, or somewhere else, and can include
topics such as:
Job safety, work ethics or other
regulations,
Equipment use,
Communication, sensitivity, or teambuilding,
Computer or technical skills,
Management skills, and
Other job skills.
OTHER THAN COLLEGE CLASSES YOU MAY
HAVE DESCRIBED EARLIER, have you completed
any work-related training in the past 12
months?
□
No
□
Yes
GO TO question 52 on page 21.
46. How many work-related trainings have you
completed in the past 12 months?
Count multiple sessions of the same training as
one training.
Number of trainings:
CONTINUE ON page 18.
17
47. Please fill out a column in the following grid for each work-related training you have had in the past
12 months.
If you had more than three, answer for the last three you had.
Training
#1
Training
#2
Training
#3
47a. In your own words, what
was the topic or title of
this training?
47b. Using Table D on page 19,
which general category
best fits this training?
47c. In total, how many hours
did this training last? Count
less than 1 hour as 1 hour.
47d. Was this training for your
current job? (Mark one.)
Number from
Table D:
Number from
Table D:
_______ hours
_______ hours
Number from
Table D:
_______ hours
□ No
□ No
□ No
□ Yes, and it was
□ Yes, and it was
□ Yes, and it was
required
required
□ Yes, but it was
not required
□ Yes, but it was
not required
required
□ Yes, but it was
not required
47e. To what extent was this
training useful for your
work? (Mark one.)
□ Not at all
□ Not at all
□ Not at all
□ Somewhat
□ Somewhat
□ Somewhat
□ A great deal
□ A great deal
□ A great deal
47f. Did you take this training
to earn, maintain, or
renew a professional
certification or license?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
18
TABLE D. TRAINING CATEGORIES FOR QUESTION 47b
1 New employee orientation: Provides
information for new employees to familiarize
them with the workplace and with workplace
practices and policies.
4 Communication or team training: Includes
training to improve communication in the
workplace or how to work in teams or groups.
5 Supervisory/management training: Includes
training in supervising employees and in
implementing employment practices,
regulations, and policies related to personnel or
budget management.
2 Compliance training: Provides information on
company, professional, or government policies
and regulations concerning legal and ethical
issues.
3 Safety training: Provides information on
workplace safety, including safety procedures
and processes.
6 Job skills training: Includes all other training to
develop the professional or technical skills
needed to do your work, such as sales and
customer relations training, use of computer
applications, and other skills that you use on
your job.
19
49. How much did you pay for all of the workrelated training you had in the past 12 months?
$
.00
51. To what extent do each of the following factors
motivate you to take work-related training?
Enter 0 if you did not
pay any training costs
or if all your costs
were reimbursed.
a. Your employer’s requirements. (Mark
one.)
□ Not at all
□ Somewhat
□ A great deal
50. Thinking of all the work-related training you
had in the past 12 months, how useful was it
for each of the following?
b. Certification, licensing, or government
requirements. (Mark one.)
a. Increasing your pay. (Mark one.)
□
□
□
□
□ Not at all
□ Somewhat
□ A great deal
Too soon to tell
Not useful
Somewhat useful
Very useful
c. Your desire to do your job better. (Mark
one.)
b. Keeping you marketable to employers
or clients. (Mark one.)
□
□
□
□
□ Not at all
□ Somewhat
□ A great deal
Too soon to tell
Not useful
Somewhat useful
Very useful
d.
c. Improving your work skills. (Mark
one.)
□
□
□
□
Your desire to move up in your career.
(Mark one.)
□ Not at all
□ Somewhat
□ A great deal
Too soon to tell
Not useful
Somewhat useful
Very useful
20
57. During the last 4 weeks, have you been actively
looking for work?
Employment
52. Last week, were you employed for pay at a job
or business?
□
□
If you were temporarily absent from a job or
business (on vacation, temporarily ill, on
maternity leave, etc.), answer “Yes”.
□ No
GO TO question 56.
□
□
□
53. For the job or business you were in last week,
were you a member of a labor union or of an
employee association similar to a union (for
example, AFL-CIO, Change to Win Federation,
NEA)?
□
No
Yes
I worked at a full-time
job (job of 35 hours or
more per week)
I worked at one or more part-time jobs
(no full-time job)
No
Yes
Never worked
for pay
GO TO question
73 on page 23.
□
Over 12 months
ago
GO TO question
63 on page 22.
□
Within the past
12 months
□
□
□
□
□
□
50 to 52 weeks
48 to 49 weeks
40 to 47 weeks
27 to 39 weeks
14 to 26 weeks
13 weeks or less
GO TO question 60.
61. During the past 12 months, in the weeks you
worked, how many hours did you usually work
each WEEK?
56. Last week, were you on layoff from a job?
□
□
□
60. During the past 12 months (52 weeks), how
many weeks did you work, including paid
vacation, paid sick leave, and military service?
(Mark one.)
GO TO
question 60.
55. Would you have preferred to work at a fulltime job?
□
□
No
Yes
I don’t know
59. When did you last work, even for a few days?
54. Which one of the following best describes your
employment situation last week? (Mark one.)
□
GO TO question 59.
58. Do you intend to look for work within the next
5 years?
□ Yes
□
□
No
Yes
No
Yes
Usual hours worked each WEEK:
21
62. Which category best fits your earnings from
wages, salary, commissions, bonuses or tips,
from all jobs over the past 12 months? (Mark
one.)
64. For whom did you work?
□
Report amount before deductions for taxes,
bonds, dues, or other items.
□
□
□
□
□
□
□
□
□
$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $75,000
$75,001 to $150,000
$150,001 or more
If now on active duty in the Armed
Forces, mark (X) this box and print the
branch of the Armed Forces below. All
others, enter name of company,
business, or other employer below.
Name of company, business, or other
employer:
65. What kind of business or industry was this?
(For example: hospital, newspaper publishing,
mail order house, auto engine manufacturing,
bank)
63. For the next few questions, please describe
your chief job activity or business last week.
If you had more than one job, describe the one
at which you worked the most hours. If you had
no job or business last week, give information
for your last job or business.
66. What kind of work were you doing?
In your current or last job, which one of the
following were you? (Mark one.)
□
□
□
□
□
□
□
(For example: registered nurse, personnel
manager, supervisor of order department,
secretary, accountant)
An employee of a private for-profit
company or business, or of an
individual, for wages, salary, or
commissions
An employee of a private not-for-profit,
tax-exempt, or charitable organization
A local government employee (city,
county, etc.)
A state government employee
A Federal government employee
Self-employed in own business,
professional practice, or farm
Working without pay in family business
or farm
67. What were your most important activities or
duties?
(For example: patient care, directing hiring
policies, supervising order clerks, typing and
filing, reconciling financial records)
22
68. What kind of position did you hold? (Mark
one.)
□
□
□
Background
73. Have you ever served on active duty in the U.S.
Armed Forces, Reserves, or National Guard?
(Mark one.)
GO TO
Permanent
question 70.
Temporary with
no set end date
Temporary with set end date
GO TO
No, never served
question 75.
in the military
□ Yes, but only on active duty
for training in the Reserve or
National Guard
□ Yes, on active duty now or in past
□
69. Would you have preferred to work at a
permanent job?
□
□
No
Yes
74. Have you served on active duty since
September 2001?
70. How many people worked for your employer?
Count employees at all locations. (Mark one.)
□ No
□ Yes
75. Do you speak a language other than English at
home?
If you were self-employed, how many people
worked for you, including yourself?
□
□
□
□
1—49 people
50—499 people
500—999 people
1,000 or more people
71. How supportive was your employer of your
training needs? (Mark one.)
□
□
□
□
□
No
□
Yes
GO TO question 77.
76. How well do you speak English? (Mark one.)
□
□
□
□
Not at all supportive
Somewhat supportive
Very supportive
Not applicable
Very well
Well
Not well
Not at all
77. Are you male or female?
72. When you started your current job, did it have
a clear training path laid out, or did you need
to figure out on your own what training you
needed? (Mark one.)
□
□
□
□
□
Male
Female
78. How old are you?
A clear training path was laid out
Some parts of the training path
were clear
I needed to figure it out on my own
years old
79. Are you of Hispanic or Latino origin?
□
□
23
No
Yes
80. What is your race? Choose one or more.
□
□
□
□
□
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
81. What is your current marital or partner status?
(Mark one.)
□
□
□
□
□
Married
In a registered domestic partnership or
civil union
Living with a partner
Widowed, divorced, or separated
Never married
Thank You.
Please return this questionnaire in the postagepaid envelope provided. If you have lost the
envelope, mail the completed questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
24
Commonly Asked Questions
Q: How was my household chosen?
A: Your address was randomly selected from among all of the home addresses in the nation. It was selected
using scientific sampling methods to represent other U.S. households. The sample was designed so that
surveys of only a few thousand people will accurately describe the educational experiences of almost all
Americans.
Q: Why should I participate? Do I have to do this?
A: Your answers are very important to the success of this study. You represent thousands of other adults like
yourself, and you cannot be replaced. This survey is voluntary. You may choose not to answer any or all
questions in this survey, but in order for the survey to be representative, it is important that you complete
and return it. Those who do not return the survey will not be represented in statistics used by policymakers
and researchers. There are no penalties should you choose not to participate in the study.
Q: Will the information I provide be kept confidential? Will my privacy be protected?
A: Yes. Your responses will be combined with those from other adults to produce statistical summaries about
education and training in the United States. Your individual data will not be reported. Your answers may
be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other
purpose except as required by law (20 USC § 9573).
Q: How will my response help the Federal Government?
A: The U.S. Departments of Education and Labor want to understand how adults acquire and maintain the
skills they need for work. This survey is the only way these Departments can learn about the education
and training that adults receive from schools, employers, and other training sponsors. The survey will
allow policymakers and researchers to better understand the demand for education and training programs,
and can help direct national policy in these areas. Your responses will be combined with those from other
households to inform educators, policy makers, and schools about how adults in the U.S. learn the skills
needed for work.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics (NCES), within the U.S. Department of Education, is
authorized to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this survey on
behalf of NCES. This study has been approved by the Office of Management and Budget (OMB), the
office that reviews all federally sponsored surveys. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. The OMB approval number assigned to this study is 1850-0803. You may send any comments
about this survey, including its length, to the Federal Government. Write to: Lisa Hudson, National Center
for Education Statistics, U.S. Department of Education, 1990 K Street NW, Washington, DC 20006-5650.
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to xxxx@census.gov or you may call the
Census Bureau toll-free at 1-800-xxx-xxxx.
25
C.2 Credentials for Work Survey (CWS) for national sample
OMB No. 1850-0803: Approval Expires 09/30/2016
Credentials for Work Survey
Part of the 2014 National Household Education Survey
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
2
Instructions
In response to the survey you answered earlier, we recorded that the
person listed below is between the ages of 16 to 65, is no longer in high
school, and lives in this household. If this information is not correct,
please call us at the toll-free number below so we can be sure you
received the correct survey.
These questions should be filled out by:
No one else in the household should fill out the survey.
To answer a question, simply mark the box [X] that best represents your
answer.
Use a black or blue pen, if available, to complete this survey.
Please return the completed survey using the postage-paid envelope
provided.
If you have any questions about this survey, please call us at our tollfree number: 1-888-xxx-xxxx.
We are authorized to collect this information by U.S. Code, Title 20, Section 9543. You do not have to provide
the information requested. However, the information you provide will help the Department of Education’s
ongoing efforts to learn more about the educational experiences of adults. There are no penalties should you
choose not to participate in this study. Your answers may be used only for statistical purposes and may not be
disclosed, or used, in identifiable form for any other purpose except as required by law (U.S. Code, Title 20,
Section 9573). Your responses will be combined with those from other participants to produce summary
statistics and reports.
Depending on your background, this survey is estimated to take 10 to 20 minutes, including time for reviewing
instructions and completing the survey. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: Lisa Hudson, National Center for Education Statistics, U.S.
Department of Education, 1990 K Street NW, Washington, DC 20006-5650. Do not return the completed form
to this address.
3
Educational Attainment
Certification and Licensure
1. What is the highest degree or level of school
you have completed? (Mark one.)
3. Do you have a currently active professional
certification or a state or industry license? Do
not include business licenses, such as a liquor
license or vending license.
□ Elementary or high school,
but no high school diploma or GED
□ High school diploma
GO TO
question 3.
□ GED, or alternative credential
□ Some college credit but less
than one year of college credit
A professional certification or license shows you
are qualified to perform a specific job and includes
things like Licensed Realtor, Certified Medical
Assistant, Certified Construction Manager, or an IT
certification.
□ No
□ 1 or more years of college credit,
no degree
GO TO question 10 on page 10.
□ Yes
□ Associate’s degree (for example, AA, AS)
□ Bachelor’s degree (for example, BA, BS)
4. How many certifications and licenses do
you have?
□ Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)
If you had to get a certification in order to
get a license, count each certification and
license separately.
□ Professional degree beyond a bachelor’s
degree (for example, MD, DDS, DVM, LLB,
JD)
Number of certifications and licenses:
□ Doctorate degree (for example, PhD, EdD)
CONTINUE on page 6.
2. Using Table A on page 5, what was the major
or field of study for your highest level of
education?
If there was more than one, please choose the
one you consider most important.
Number from Table A on page 5:
4
TABLE A. FIELD OF STUDY CODES FOR QUESTION 2
1
Accounting, finance, insurance, or real
estate
21 Law enforcement, security, or
firefighting
2
Administrative support
22 Journalism or communications
3
Agriculture
23 Law or legal studies
4
Architecture
24 Leisure or fitness studies
5
Arts, music, or design
25 Liberal arts
6
Biological/biomedical sciences
26 Library science
7
8
Business management or marketing
Communications technologies (e.g.,
printing, broadcasting, recording, and
graphics technologies)
27 Manufacturing or production (e.g.,
machinist, welder, boilermaker)
9
28 Mathematics or statistics
29 Mechanic or repair technologies
Computer and information sciences
30 Military science/technologies
10 Construction trades
31 Natural resources or conservation
11 Cosmetology or barbering
32 Philosophy or comparative religions
12 Culinary arts
33 Physical sciences
13 Drafting, engineering technologies, or
science technologies
34 Psychology
35 Religious vocations or theology
14 Education
36 Social or human services or public
administration
15 Engineering
16 English language/literature
37 Social sciences (e.g., anthropology,
gender or ethnic studies) or history
17 Family and consumer sciences
18 Foreign languages
38 Transportation or materials moving
39 Interdisciplinary
19 Funeral/mortuary services
20 Healthcare professions
5
5. Please fill out a column in the following grid for each currently active certification and license you have,
up to three.
If you have more than three, answer for the three you last earned or renewed.
Certification or License
#1
Certification or License
#2
Certification or License
#3
5a. In your own words, what is
the name of the
certification or license?
5b. Using Table B on page 7,
what is its subject field?
Number
from Table B:
Number
from Table B:
Number
from Table B:
5c. Could you use it to get a
job with another employer
in that field?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
□ I don’t know
□ I don’t know
□ I don’t know
5d. Did you have to pass a test,
submit a portfolio, or
demonstrate your skills to
get it?
□ No
□ Yes
□ No
□ Yes
□ No
□ Yes
5e. Was it awarded by the
federal, state, or local
government?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
□ I don’t know
□ I don’t know
□ I don’t know
□ No
□ No
□ No
□ Yes, and it is
□ Yes, and it is
□ Yes, and it is
required
required
required
(For example, by a state
board of education or other
state board, OSHA, or FAA)
5f. Is it for your current job?
(Mark one.)
□ Yes, but it is not
□ Yes, but it is not
required
5g. In what year did you last
earn or renew it?
□ Yes, but it is not
required
Year:
Year:
6
required
Year:
TABLE B. FIELD OF CERTIFICATION OR LICENSE CODES FOR QUESTION 5b
1
EMT, CPR, or basic first aid
11 Law or legal support
2
Other health care (for fitness use code 13)
Includes health-care technologist or
technician; health-care therapist (for
counseling use code 17); nursing
occupations, medical practitioners (such as
MD, OD, PA, DC, PharmD, DVM), and healthcare specialties such as ACLS.
12 Notary public
3
Architecture, engineering, or energy
Includes architecture, drafting, engineering,
engineering technologies, LEED, energy
auditing and other similar fields.
4
Business management, operations, and
support
Includes project management, Six Sigma,
Lean Manufacturing, and other business
management, support, and operations.
5
Childcare
6
Cosmetology or barbering
7
Finance, insurance, or real estate
Includes insurance, real estate, taxes
and accounting, and other finance (for
notary public use code 12).
8
9
13 Physical fitness
Includes personal or athletic trainer,
yoga instructor, and other fitness
instruction.
14 Public safety
Includes law enforcement, firefighting,
flight attendant, and other public safety
services (for water and hazardous waste
treatment use code 8).
15 Religious ordination
16 Skilled trades
Includes automotive repair, HVAC
installation and repair, construction trades
(carpenter, electrician, mason, plumber),
welder, and machining or equipment
operator (such as boiler, crane, or forklift
operator).
17 Social work or counseling
18 Teaching (public or private schools)
Includes preschool through grade 12
teaching. (For other instructional fields, use
the code for that field; for example, flight
instructors use code 19 for transportation.)
Food handling and sanitation
Includes food handling, water treatment and
sanitation, hazardous waste operations, and
other food handling and sanitation fields.
19 Transportation
Includes CDL, aviation or marine piloting,
and other transportation work (for flight
attendant use code 14).
Funeral, mortuary, and taxidermy
10 Information technology
Includes software development and
applications, networking, hardware, and
other computer and information
technologies.
20 Other fields not listed above
7
The rest of this section asks about the
certification or license you last earned or
renewed – that is, the one with the most
recent year in question 5g on page 5.
7. Which of the following prepared you to earn this
certification or license? (Mark ALL that apply.)
□ I earned a college degree.
□ I took other classes from a college,
6. How useful has your last certification or
license been for each of the following?
□
a. Getting a job. (Mark one.)
□
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
technical school, or trade school.
I took classes or training from a company,
association, union, or private instructor.
I studied on my own using textbooks or
on-line resources.
I participated in on-the-job training, an
internship, or apprenticeship.
I did not take any classes, training, or
instruction.
b. Keeping a job. (Mark one.)
□
□
□
□
8. How often do you have to renew this
certification or license? (Mark one.)
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
□
□
□
□
c. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□ Renew it
□ Let it expire
□ I don’t know
Too soon to tell
Not useful
Somewhat useful
Very useful
CONTINUE on page 10.
e. Improving your job skills. (Mark one.)
□
□
□
□
GO TO
question 10
on page 10.
9. What do you plan to do the next time this
certification or license is up for renewal? (Mark
one.)
d. Keeping you marketable to employers or
clients. (Mark one.)
□
□
□
□
I do not have to renew it
Once a year
Every 2 years
Every 3 years
Every 4 years
Every 5 or more years
Too soon to tell
Not useful
Somewhat useful
Very useful
8
This page left blank intentionally.
9
14. Did you get this educational certificate in order
to earn a professional certification or license?
Educational Certificates
□ No
10. After leaving high school, some people take
classes at a college, technical school, or trade
school to earn an educational certificate.
□ Yes
This educational certificate is sometimes called a
diploma, for example a cosmetology diploma.
But it is not a high school diploma. It is also not a
college degree or a professional certification.
15. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
An educational certificate is awarded only by
schools.
□ Not at all
□ Somewhat
□ A great deal
Have you ever earned this type of educational
certificate?
□
No
□
Yes
16. What type of school awarded this educational
certificate? (Mark one.)
GO TO question 26 on page 13.
□ Trade or vocational school; community
or technical college
The next few questions ask about your last
educational certificate.
□ Other college or university
□ Other type of school (specify)
11. About how many hours of instruction did you
complete in order to earn your last educational
certificate? (Mark one.)
17. Was this educational certificate earned as part
of a bachelor’s or master’s degree, or as an
add-on to a degree?
□ 160 or more hours (4 or more full-time
weeks)
□ 40-159 hours (1 week to less than four
full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
□ No
□ Yes
18. Do you have another educational certificate?
12. Using Table C on page 11, what was the field of
study for this educational certificate?
Number from Table C:
□
No
□
Yes
CONTINUE
ON page 12.
13. In what year did you get this educational
certificate?
Year:
10
GO TO question 26 on page 13.
TABLE C. FIELD OF STUDY CODES FOR QUESTIONS 12 AND 20
1
2
3
4
5
6
7
8
9
Accounting, finance, insurance, or
real estate
Administrative support
Arts, music, or design
Business management or
marketing
Communications technologies (e.g.
printing, broadcasting, recording,
and graphics technologies)
Computer and information sciences
Construction trades
Cosmetology or barbering
Culinary arts
10
11
12
13
14
15
16
17
18
19
20
11
Drafting, engineering technologies, or
science technologies
Education
Funeral/mortuary services
Healthcare professions
Law enforcement, security, or firefighting
Legal studies
Manufacturing or production (e.g.,
machinist, welder, boilermaker)
Mechanic or repair technologies
Religious vocations or theology
Transportation or materials moving
Other field of study not listed above
The next few questions ask about your next-to-last
educational certificate.
24. What type of school awarded this educational
certificate? (Mark one.)
19. Thinking about your next-to-last educational
certificate, about how many hours of
instruction did you complete in order to earn
it? (Mark one.)
□ Trade or vocational school; community or
technical college
□ Other college or university
□ Other type of school (specify)
□ 160 or more hours (4 or more full-time
weeks)
□ 40-159 hours (1 full-time week to less
than four full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
25. Was this educational certificate earned as part
of a bachelor’s or master’s degree, or as an
add-on to a degree?
□ No
20. Using Table C on page 11, what was the field of
study for this educational certificate?
□ Yes
Number from Table C:
21. In what year did you get this educational
certificate?
Year:
22. Did you get this educational certificate in order
to earn a professional certification or license?
□ No
□ Yes
23. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
□ Not at all
□ Somewhat
□ A great deal
12
30. As part of this apprenticeship, did you take any
formal classes? Include any classes taken inperson or on-line. (Mark all that apply.)
Apprenticeships
26. Have you ever completed an apprenticeship?
□ No
□ Yes, from an employer or union
□ Yes, from a community or technical college
Do not count student teaching, medical
internships or residency, externships, or unpaid
internships.
□
No
□
Yes
or other college
□ Yes, from another organization
GO TO question 36 on page 14.
31. What wage did you earn during this
apprenticeship program? (Mark one.)
The rest of this section asks about the last
apprenticeship you completed.
□ No wage
□ A low starting wage that increased as you
27. Who sponsored the apprenticeship? (Mark
one.)
□
□
□
□
□
□
□
became more qualified during the
apprenticeship
□ A low starting wage that increased only
when I became fully qualified at the end of
the apprenticeship
□ The same wage as a fully qualified worker
The U.S. military
Federal civilian government
State or local government
A (non-military) employer
An employer-union partnership
Other sponsor
I don’t know
32. What type of occupation was this
apprenticeship for? (Mark one.)
□
□
□
□
□
□
□
□
□
□
□
□
□
28. Did this apprenticeship lead to a Certificate of
Completion of Apprenticeship from your state
or from the U.S. government?
□
□
□
No
Yes
I don’t know
29. How long did this apprenticeship last? (Mark
one.)
□
□
□
□
□
Less than 1 year
1 year
2 years
3 years
4 years or more
13
Construction trades
Driving or transport
Engineering or architecture
Food preparation
Health care
Information technology (IT)
Management
Manufacturing, printing, or production
Mechanic, installation, or repair
Public safety or corrections
Real estate, finance, or insurance
Other sales or customer service
Other (specify)
College Classes
33. How useful was your apprenticeship for each of
the following?
36. How many college classes have you taken in
the past 12 months?
a. Getting a job. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
Count only classes you completed or are
currently taking.
□ I have not taken any
b. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
Number of college classes:
37. How many of these classes were not for college
credit (that is, non-credit)?
Count only classes you completed within the
past 12 months or are currently taking.
c. Improving your job skills. (Mark one.)
□
□
□
□
GO TO question
39 on page 15.
college classes in the
past 12 months.
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
□
□
□
34. Are you currently working in the occupation
that you apprenticed in?
I don’t know
None
One
Two
Three or more
GO TO question 39 on
page 15.
38. Thinking of the last non-credit class you took,
which of the following describe why you took
this class? (Mark all that apply.)
□ No
□ Yes
□ To prepare for or to consider further
35. In your current job, how often do you use the
skills that you learned in your apprenticeship?
□
□
If you are not employed, please answer “Never
or almost never”.
□
□
□ Never or almost never
□ Sometimes
□ All or most of the time
14
education
For personal interest
To earn, maintain, or renew a
professional certification or license
For my current job
For another work-related reason
Training for Work
Employment
39. People often participate in courses, training, or
other instruction for work.
41. Last week, were you employed for pay at a job
or business?
These trainings can include classes, seminars, or
workshops. They can be taken at the workplace,
on-line, or somewhere else, and can include
topics such as:
If you were temporarily absent from a job or
business (on vacation, temporarily ill, on
maternity leave, etc.), answer “Yes”.
□ No
Job safety, work ethics or other
regulations,
Equipment use,
Communication, sensitivity, or teambuilding,
Computer or technical skills,
Management skills, and
Other job skills.
□ Yes
42. Which one of the following best describes your
employment situation last week? (Mark one.)
□
OTHER THAN COLLEGE CLASSES YOU MAY
HAVE DESCRIBED EARLIER, have you completed
any work-related training in the past 12
months?
□
No
□
Yes
GO TO question 44.
□
GO TO
I worked at a full-time
question 48
job (job of 35 hours or
on page 16.
more per week)
I worked at one or more part-time jobs
(no full-time job)
43. Would you have preferred to work at a fulltime job?
GO TO question 41.
□
□
40. How many work-related trainings have you
completed in the past 12 months?
No
Yes
GO TO question 48 on page 16.
44. Last week, were you on layoff from a job?
□
□
Count multiple sessions of the same training as
one training.
No
Yes
45. During the last 4 weeks, have you been actively
looking for work?
Number of trainings:
□
□
No
Yes
GO TO question 47 on page 16.
46. Do you intend to look for work within the next
5 years?
□
□
□
15
No
Yes
I don’t know
47. When did you last work, even for a few days?
□
Never worked
for pay
□
Over 12 months
ago
□
Within the past
12 months
51. For the next few questions, please describe
your chief job activity or business last week.
GO TO question
58 on page 17.
If you had more than one job, describe the one
at which you worked the most hours. If you had
no job or business last week, give information
for your last job or business.
GO TO question 51.
In your current or last job, which one of the
following were you? (Mark one.)
□
48. During the past 12 months (52 weeks), how
many weeks did you work, including paid
vacation, paid sick leave, and military service?
(Mark one.)
□
□
□
□
□
□
□
50 to 52 weeks
48 to 49 weeks
40 to 47 weeks
27 to 39 weeks
14 to 26 weeks
13 weeks or less
□
□
□
□
49. During the past 12 months, in the weeks you
worked, how many hours did you usually work
each WEEK?
□
Usual hours worked each WEEK:
52. For whom did you work?
50. Which category best fits your earnings from
wages, salary, commissions, bonuses or tips,
from all jobs over the past 12 months? (Mark
one.)
□
Report amount before deductions for taxes,
bonds, dues, or other items.
□
□
□
□
□
□
□
□
□
An employee of a private for-profit
company or business, or of an
individual, for wages, salary, or
commissions
An employee of a private not-for-profit,
tax-exempt, or charitable organization
A local government employee (city,
county, etc.)
A state government employee
A Federal government employee
Self-employed in own business,
professional practice, or farm
Working without pay in family business
or farm
If now on active duty in the Armed
Forces, mark (X) this box and print the
branch of the Armed Forces below. All
others, enter name of company,
business, or other employer below.
Name of company, business, or other
employer:
$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $75,000
$75,001 to $150,000
$150,001 or more
16
53. What kind of business or industry was this?
Background
(For example: hospital, newspaper publishing,
mail order house, auto engine manufacturing,
bank)
58. Have you ever served on active duty in the U.S.
Armed Forces, Reserves, or National Guard?
(Mark one.)
GO TO
No, never served
question 60.
in the military
□ Yes, but only on active duty
for training in the Reserve or
National Guard
□ Yes, on active duty now or in past
□
54. What kind of work were you doing?
(For example: registered nurse, personnel
manager, supervisor of order department,
secretary, accountant)
59. Have you served on active duty since
September 2001?
□
□
No
Yes
60. Do you speak a language other than English at
home?
55. What were your most important activities or
duties?
□
□
(For example: patient care, directing hiring
policies, supervising order clerks, typing and
filing, reconciling financial records)
No
Yes
GO TO question 62.
61. How well do you speak English? (Mark one.)
□
□
□
□
56. What kind of position did you hold? (Mark
one.)
□
□
□
Very well
Well
Not well
Not at all
62. Are you male or female?
□
□
GO TO
Permanent
question 58.
Temporary with
no set end date
Temporary with set end date
Male
Female
63. How old are you?
years old
57. Would you have preferred to work at a
permanent job?
□
□
64. Are you of Hispanic or Latino origin?
No
Yes
□
□
17
No
Yes
65. What is your race? Choose one or more.
□
□
□
□
□
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
66. What is your current marital or partner status?
(Mark one.)
□
□
□
□
□
Married
In a registered domestic partnership or
civil union
Living with a partner
Widowed, divorced, or separated
Never married
Thank you.
Please return this questionnaire in the postage-paid
envelope provided. If you have lost the envelope,
mail the completed questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
18
Commonly Asked Questions
Q: How was my household chosen?
A: Your address was randomly selected from among all of the home addresses in the nation. It was selected
using scientific sampling methods to represent other U.S. households. The sample was designed so that
surveys of only a few thousand people will accurately describe the educational experiences of almost all
Americans.
Q: Why should I participate? Do I have to do this?
A: Your answers are very important to the success of this study. You represent thousands of other adults like
yourself, and you cannot be replaced. This survey is voluntary. You may choose not to answer any or all
questions in this survey, but in order for the survey to be representative, it is important that you complete
and return it. Those who do not return the survey will not be represented in statistics used by policymakers
and researchers. There are no penalties should you choose not to participate in the study.
Q: Will the information I provide be kept confidential? Will my privacy be protected?
A: Yes. Your responses will be combined with those from other adults to produce statistical summaries about
education and training in the United States. Your individual data will not be reported. Your answers may
be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other
purpose except as required by law (20 USC § 9573).
Q: How will my response help the Federal Government?
A: The U.S. Departments of Education and Labor want to understand how adults acquire and maintain the
skills they need for work. This survey is the only way these Departments can learn about the education
and training that adults receive from schools, employers, and other training sponsors. The survey will
allow policymakers and researchers to better understand the demand for education and training programs,
and can help direct national policy in these areas. Your responses will be combined with those from other
households to inform educators, policy makers, and schools about how adults in the U.S. learn the skills
needed for work.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics (NCES), within the U.S. Department of Education, is
authorized to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this survey on
behalf of NCES. This study has been approved by the Office of Management and Budget (OMB), the
office that reviews all federally sponsored surveys. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. The OMB approval number assigned to this study is 1850-0803. You may send any comments
about this survey, including its length, to the Federal Government. Write to: Lisa Hudson, National Center
for Education Statistics, U.S. Department of Education, 1990 K Street NW, Washington, DC 20006-5650.
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to xxxx@census.gov or you may call the
Census Bureau toll-free at 1-800-xxx-xxxx.
19
C.3 ATES for seeded sample
OMB No. 1850-0803: Approval Expires 09/30/2016
Adult Training and Education Survey
Part of the 2014 National Household Education Survey
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this next step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
2
Instructions
These questions should be filled out by:
No one else in the household should fill out the survey.
To answer a question, simply mark the box [X] that best represents your
answer.
Use a black or blue pen, if available, to complete this survey.
Please return the completed survey using the postage-paid envelope
provided.
If you have any questions about this survey, please call us at our tollfree number: 1-888-xxx-xxxx.
We are authorized to collect this information by U.S. Code, Title 20, Section 9543. You do not have to provide
the information requested. However, the information you provide will help the Department of Education’s
ongoing efforts to learn more about the educational experiences of adults. There are no penalties should you
choose not to participate in this study. Your answers may be used only for statistical purposes and may not be
disclosed, or used, in identifiable form for any other purpose except as required by law (U.S. Code, Title 20,
Section 9573). Your responses will be combined with those from other participants to produce summary
statistics and reports.
Depending on your background, this survey is estimated to take 10 to 20 minutes, including time for reviewing
instructions and completing the survey. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: Lisa Hudson, National Center for Education Statistics, U.S.
Department of Education, 1990 K Street NW, Washington, DC 20006-5650. Do not return the completed form
to this address.
3
Educational Attainment
Certification and Licensure
1. What is the highest degree or level of school
you have completed? (Mark one.)
3. Do you have a currently active professional
certification or a state or industry license? Do
not include business licenses, such as a liquor
license or vending license.
□ Elementary or high school,
but no high school diploma or GED GO TO
question 3.
□ High school diploma
□ GED, or alternative credential
□ Some college credit but less
than one year of college credit
A professional certification or license shows you
are qualified to perform a specific job and includes
things like Licensed Realtor, Certified Medical
Assistant, Certified Construction Manager, or an IT
certification.
□ No
□ 1 or more years of college credit,
no degree
GO TO question 10 on page 10.
□ Yes
□ Associate’s degree (for example, AA, AS)
□ Bachelor’s degree (for example, BA, BS)
4. How many certifications and licenses do
you have?
□ Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)
□ Professional degree beyond a bachelor’s
If you had to get a certification in order to
get a license, count each certification and
license separately.
□ Doctorate degree (for example, PhD, EdD)
Number of certifications and licenses:
degree (for example, MD, DDS, DVM, LLB,
JD)
2. Using Table A on page 5, what was the major
or field of study for your highest level of
education?
CONTINUE on page 6.
If there was more than one, please choose the
one you consider most important.
Number from Table A on page 5:
4
TABLE A. FIELD OF STUDY CODES FOR QUESTION 2
1
Accounting, finance, insurance, or real
estate
21 Law enforcement, security, or
firefighting
2
Administrative support
22 Journalism or communications
3
Agriculture
23 Law or legal studies
4
Architecture
24 Leisure or fitness studies
5
Arts, music, or design
25 Liberal arts
6
Biological/biomedical sciences
26 Library science
7
8
Business management or marketing
Communications technologies (e.g.,
printing, broadcasting, recording, and
graphics technologies)
27 Manufacturing or production (e.g.,
machinist, welder, boilermaker)
9
28 Mathematics or statistics
29 Mechanic or repair technologies
Computer and information sciences
30 Military science/technologies
10 Construction trades
31 Natural resources or conservation
11 Cosmetology or barbering
32 Philosophy or comparative religions
12 Culinary arts
33 Physical sciences
13 Drafting, engineering technologies, or
science technologies
34 Psychology
35 Religious vocations or theology
14 Education
36 Social or human services or public
administration
15 Engineering
16 English language/literature
37 Social sciences (e.g., anthropology,
gender or ethnic studies) or history
17 Family and consumer sciences
18 Foreign languages
38 Transportation or materials moving
39 Interdisciplinary
19 Funeral/mortuary services
20 Healthcare professions
5
5. Please fill out a column in the following grid for each currently active certification and license you have,
up to three.
If you have more than three, answer for the three you last earned or renewed.
Certification or License
#1
Certification or License
#2
Certification or License
#3
5a. In your own words, what is
the name of the
certification or license?
5b. Using Table B on page 7,
what is its subject field?
Number
from Table B:
Number
from Table B:
Number
from Table B:
5c. Could you use it to get a
job with another employer
in that field?
□ No
□ No
□ No
□ I don’t know
□ I don’t know
□ I don’t know
5d. Did you have to pass a test,
submit a portfolio, or
demonstrate your skills to
get it?
□ No
□ Yes
□ No
□ Yes
□ No
□ Yes
5e. Was it awarded by the
federal, state, or local
government?
□ No
□ No
□ No
□ I don’t know
□ I don’t know
□ I don’t know
(For example, by a state
board of education or other
state board, OSHA, or FAA)
5f. Is it for your current job?
(Mark one.)
□ Yes
□ Yes
□ Yes
□ Yes
□ No
□ No
□ Yes
□ No
□ Yes, and it is
□ Yes, and it is
□ Yes, and it is
□ Yes, but it is not
□ Yes, but it is not
□ Yes, but it is not
required
required
required
5g. In what year did you last
earn or renew it?
□ Yes
Year:
required
Year:
6
required
required
Year:
TABLE B. FIELD OF CERTIFICATION OR LICENSE CODES FOR QUESTION 5b
1
EMT, CPR, or basic first aid
11 Law or legal support
2
Other health care (for fitness use code 13)
Includes health-care technologist or
technician; health-care therapist (for
counseling use code 17); nursing
occupations, medical practitioners (such as
MD, OD, PA, DC, PharmD, DVM), and healthcare specialties such as ACLS.
12 Notary public
3
Architecture, engineering, or energy
Includes architecture, drafting, engineering,
engineering technologies, LEED, energy
auditing and other similar fields.
4
Business management, operations, and
support
Includes project management, Six Sigma,
Lean Manufacturing, and other business
management, support, and operations.
5
Childcare
6
Cosmetology or barbering
7
Finance, insurance, or real estate
Includes insurance, real estate, taxes
and accounting, and other finance (for
notary public use code 12).
8
9
13 Physical fitness
Includes personal or athletic trainer,
yoga instructor, and other fitness
instruction.
14 Public safety
Includes law enforcement, firefighting,
flight attendant, and other public safety
services (for water and hazardous waste
treatment use code 8).
15 Religious ordination
16 Skilled trades
Includes automotive repair, HVAC
installation and repair, construction trades
(carpenter, electrician, mason, plumber),
welder, and machining or equipment
operator (such as boiler, crane, or forklift
operator).
17 Social work or counseling
18 Teaching (public or private schools)
Includes preschool through grade 12
teaching. (For other instructional fields, use
the code for that field; for example, flight
instructors use code 19 for transportation.)
Food handling and sanitation
Includes food handling, water treatment and
sanitation, hazardous waste operations, and
other food handling and sanitation fields.
19 Transportation
Includes CDL, aviation or marine piloting,
and other transportation work (for flight
attendant use code 14).
Funeral, mortuary, and taxidermy
10 Information technology
Includes software development and
applications, networking, hardware, and
other computer and information
technologies.
20 Other fields not listed above
7
The rest of this section asks about the
certification or license you last earned or
renewed – that is, the one with the most
recent year in question 5g on page 6.
7. Which of the following prepared you to earn this
certification or license? (Mark ALL that apply.)
□ I earned a college degree.
□ I took other classes from a college,
6. How useful has your last certification or
license been for each of the following?
□
a. Getting a job. (Mark one.)
□
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
b. Keeping a job. (Mark one.)
□
□
□
□
8. How often do you have to renew this
certification or license? (Mark one.)
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
□
□
□
□
c. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□ Renew it
□ Let it expire
□ I don’t know
Too soon to tell
Not useful
Somewhat useful
Very useful
CONTINUE on page 10.
e. Improving your job skills. (Mark one.)
□
□
□
□
I do not have to renew it
Once a year
Every 2 years
Every 3 years
Every 4 years
Every 5 or more years
GO TO
question 10
on page 10.
9. What do you plan to do the next time this
certification or license is up for renewal? (Mark
one.)
d. Keeping you marketable to employers or
clients. (Mark one.)
□
□
□
□
technical school, or trade school.
I took classes or training from a company,
association, union, or private instructor.
I studied on my own using textbooks or
on-line resources.
I participated in on-the-job training, an
internship, or apprenticeship.
I did not take any classes, training, or
instruction.
Too soon to tell
Not useful
Somewhat useful
Very useful
8
This page left blank intentionally.
9
14. Did you get this educational certificate in order
to earn a professional certification or license?
Educational Certificates
□ No
10. After leaving high school, some people take
classes at a college, technical school, or trade
school to earn an educational certificate.
□ Yes
This educational certificate is sometimes called a
diploma, for example a cosmetology diploma.
But it is not a high school diploma. It is also not a
college degree or a professional certification.
15. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
An educational certificate is awarded only by
schools.
□ Not at all
□ Somewhat
□ A great deal
Have you ever earned this type of educational
certificate?
□
No
□
Yes
16. What type of school awarded this educational
certificate? (Mark one.)
GO TO question 26 on page 13.
□ Trade or vocational school; community
or technical college
The next few questions ask about your last
educational certificate.
□ Other college or university
□ Other type of school (specify)
11. About how many hours of instruction did you
complete in order to earn your last educational
certificate? (Mark one.)
□ 160 or more hours (4 or more full-time
17. Was this educational certificate earned as part
of a bachelor’s or master’s degree, or as an
add-on to a degree?
weeks)
□ 40-159 hours (1 week to less than four
full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
□ No
□ Yes
12. Using Table C on page 11, what was the field of
study for this educational certificate?
18. Do you have another educational certificate?
Number from Table C:
□
No
□
Yes
CONTINUE
ON page 12.
13. In what year did you get this educational
certificate?
Year:
10
GO TO question 26 on page 13.
TABLE C. FIELD OF STUDY CODES FOR QUESTIONS 12 AND 20
1
2
3
4
5
6
7
8
9
Accounting, finance, insurance, or
real estate
Administrative support
Arts, music, or design
Business management or
marketing
Communications technologies (e.g.
printing, broadcasting, recording,
and graphics technologies)
Computer and information sciences
Construction trades
Cosmetology or barbering
Culinary arts
10
11
12
13
14
15
16
17
18
19
20
11
Drafting, engineering technologies, or
science technologies
Education
Funeral/mortuary services
Healthcare professions
Law enforcement, security, or firefighting
Legal studies
Manufacturing or production (e.g.,
machinist, welder, boilermaker)
Mechanic or repair technologies
Religious vocations or theology
Transportation or materials moving
Other field of study not listed above
24. What type of school awarded this certificate?
(Mark one.)
The next few questions ask about your next-to-last
educational certificate.
19. Thinking about your next-to-last educational
certificate, about how many hours of
instruction did you complete in order to earn
it? (Mark one.)
□ Trade or vocational school; community or
technical college
□ Other college or university
□ Other type of school (specify)
□ 160 or more hours (4 or more full-time
weeks)
□ 40-159 hours (1 full-time week to less
than four full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
25. Was this certificate earned as part of a
bachelor’s or master’s degree, or as an add-on
to a degree?
□ No
20. Using Table C on page 11, what was the field of
study for this educational certificate?
□ Yes
Number from Table C:
21. In what year did you get this educational
certificate?
Year:
22. Did you get this educational certificate in order
to earn a professional certification or license?
□ No
□ Yes
23. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
□ Not at all
□ Somewhat
□ A great deal
12
30. As part of this apprenticeship, did you take any
formal classes? Include any classes taken inperson or on-line. (Mark all that apply.)
Apprenticeships
26. Have you ever completed an apprenticeship?
Do not count student teaching, medical
internships or residency, externships, or unpaid
internships.
□
No
□
Yes
□ No
□ Yes, from an employer or union
□ Yes, from a community or technical college
or other college
□ Yes, from another organization
GO TO question 36 on page 14.
31. What wage did you earn during this
apprenticeship program? (Mark one.)
The rest of this section asks about the last
apprenticeship you completed.
□ No wage
□ A low starting wage that increased as I
27. Who sponsored the apprenticeship? (Mark
one.)
□
□
□
□
□
□
□
became more qualified during the
apprenticeship
□ A low starting wage that increased only
when I became fully qualified at the end of
the apprenticeship
□ The same wage as a fully qualified worker
The U.S. military
Federal civilian government
State or local government
A (non-military) employer
An employer-union partnership
Other sponsor
I don’t know
32. What type of occupation was this
apprenticeship for? (Mark one.)
□
□
□
□
□
□
□
□
□
□
□
□
□
28. Did this apprenticeship lead to a Certificate of
Completion of Apprenticeship from your state
or from the U.S. government?
□
□
□
No
Yes
I don’t know
29. How long did this apprenticeship last? (Mark
one.)
□
□
□
□
□
Less than 1 year
1 year
2 years
3 years
4 years or more
13
Construction trades
Driving or transport
Engineering or architecture
Food preparation
Health care
Information technology (IT)
Management
Manufacturing, printing, or production
Mechanic, installation, or repair
Public safety or corrections
Real estate, finance, or insurance
Other sales or customer service
Other (specify)
33. How useful was your apprenticeship for each of
the following?
College and Other Classes
a. Getting a job. (Mark one.)
□
□
□
□
36. Since leaving high school, have you taken any
of the following types of classes?
Too soon to tell
Not useful
Somewhat useful
Very useful
a. Classes to learn English as a second
language (ESL). (Mark all that apply.)
□
□
□
b. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
b. Classes to prepare for the General
Educational Development (GED) test, or
some other high school equivalency
program. (Mark all that apply.)
c. Improving your job skills. (Mark one.)
□
□
□
□
No
Yes, took over 12 months ago
Yes, took within past 12 months
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
No
Yes, took over 12 months ago
Yes, took within past 12 months
c. Literacy classes to help adults read better.
Do not include college classes. (Mark all
that apply.)
34. Are you currently working in the occupation
that you apprenticed in?
□ No
□ No
□ Yes
□
□
Yes, took over 12 months ago
Yes, took within past 12 months
37. How many college classes have you taken in
the past 12 months?
35. In your current job, how often do you use the
skills that you learned in your apprenticeship?
If you are not employed, please answer “Never
or almost never”.
Count only classes you completed or are
currently taking.
□ Never or almost never
□ Sometimes
□ All or most of the time
□ I have not taken any
college classes in the
past 12 months.
GO TO question
45 on page 17.
Number of college classes:
CONTINUE WITH
question 38.
14
41. How useful was this class for each of the
following?
38. How many of these classes were not for college
credit (that is, non-credit)?
Count only classes you completed within the
past 12 months or are currently taking.
□
□
□
□
□
I don’t know
None
One
Two
Three or more
a. Increasing your pay. (Mark one.)
□
□
□
□
GO TO question 45 on
page 17.
Too soon to tell
Not useful
Somewhat useful
Very useful
b. Keeping you marketable to employers
or clients. (Mark one.)
The rest of this section asks about the last noncredit class you took.
□
□
□
□
If you took more than one non-credit class during
the same time period, please answer the questions
for the class you took earlier in the week or if on the
same day, earlier in the day.
Too soon to tell
Not useful
Somewhat useful
Very useful
c. Improving your work skills. (Mark one.)
□
□
□
□
39. What was the primary subject or field of study
for your last non-credit class?
Too soon to tell
Not useful
Somewhat useful
Very useful
42. Were you employed when you took this class?
(Mark one.)
40. Which of the following describe why you took
this class? (Mark all that apply.)
□
□
□
□ To prepare for or to consider further
□
□
□
□
education
For personal interest
To earn, maintain, or renew a
professional certification or license
For my current job
For another work-related reason
GO TO
No
question 45
on page 17.
Yes, I was self-employed.
Yes, I was employed by someone else.
43. Was this class required by your employer?
□
□
No
Yes
44. Did your employer pay for this class? Include
reimbursements from your employer. (Mark
one.)
□
□
□
15
No
Yes, partly
Yes, completely
This page left blank intentionally.
16
Training for Work
45. People often participate in courses, training, or
other instruction for work.
These trainings can include classes, seminars, or
workshops. They can be taken at the workplace,
on-line, or somewhere else, and can include
topics such as:
•
•
•
•
•
•
Job safety, work ethics or other
regulations,
Equipment use,
Communication, sensitivity, or teambuilding,
Computer or technical skills,
Management skills, and
Other job skills.
OTHER THAN COLLEGE CLASSES YOU MAY
HAVE DESCRIBED EARLIER, have you completed
any work-related training in the past 12
months?
□
No
□
Yes
GO TO question 52 on page 21.
46. How many work-related trainings have you
completed in the past 12 months?
Count multiple sessions of the same training as
one training.
Number of trainings:
CONTINUE ON page 18.
17
47. Please fill out a column in the following grid for each work-related training you have had in the past
12 months.
If you had more than three, answer for the last three you had.
Training
#1
Training
#2
Training
#3
47a. In your own words, what
was the topic or title of
this training?
47b. Using Table D on page 19,
which general category
best fits this training?
47c. In total, how many hours
did this training last? Count
less than 1 hour as 1 hour.
47d. Was this training for your
current job? (Mark one.)
Number from
Table D:
Number from
Table D:
_______ hours
_______ hours
□ No
□ Yes, and it was
required
□ No
□ Yes, and it was
required
Number from
Table D:
_______ hours
□ No
□ Yes, and it was
required
□ Yes, but it was
□ Yes, but it was
□ Yes, but it was
47e. To what extent was this
training useful for your
work? (Mark one.)
□ Not at all
□ Not at all
□ Not at all
□ A great deal
□ A great deal
□ A great deal
47f. Did you take this training
to earn, maintain, or
renew a professional
certification or license?
□ No
not required
□ Somewhat
not required
□ Somewhat
□ No
□ Yes
□ Yes
18
not required
□ Somewhat
□ No
□ Yes
TABLE D. TRAINING CATEGORIES FOR QUESTION 47b
4 Communication or team training: Includes
training to improve communication in the
workplace or how to work in teams or groups.
1 New employee orientation: Provides
information for new employees to familiarize
them with the workplace and with workplace
practices and policies.
5 Supervisory/management training: Includes
training in supervising employees and in
implementing employment practices,
regulations, and policies related to personnel or
budget management.
2 Compliance training: Provides information on
company, professional, or government policies
and regulations concerning legal and ethical
issues.
3 Safety training: Provides information on
workplace safety, including safety procedures
and processes.
6 Job skills training: Includes all other training to
develop the professional or technical skills
needed to do your work, such as sales and
customer relations training, use of computer
applications, and other skills that you use on
your job.
19
51. To what extent do each of the following factors
motivate you to take work-related training?
49. How much did you pay for all of the workrelated training you had in the past 12 months?
$
.00
Enter 0 if you did not
pay any training costs
or if all your costs
were reimbursed.
a. Your employer’s requirements. (Mark
one.)
□ Not at all
□ Somewhat
□ A great deal
50. Thinking of all the work-related training you
had in the past 12 months, how useful was it
for each of the following?
b. Certification, licensing, or government
requirements. (Mark one.)
a. Increasing your pay. (Mark one.)
□
□
□
□
□ Not at all
□ Somewhat
□ A great deal
Too soon to tell
Not useful
Somewhat useful
Very useful
c. Your desire to do your job better. (Mark
one.)
b. Keeping you marketable to employers
or clients. (Mark one.)
□
□
□
□
□ Not at all
□ Somewhat
□ A great deal
Too soon to tell
Not useful
Somewhat useful
Very useful
d.
c. Improving your work skills. (Mark
one.)
□
□
□
□
Your desire to move up in your career.
(Mark one.)
□ Not at all
□ Somewhat
□ A great deal
Too soon to tell
Not useful
Somewhat useful
Very useful
20
57. During the last 4 weeks, have you been actively
looking for work?
Employment
52. Last week, were you employed for pay at a job
or business?
□
□
If you were temporarily absent from a job or
business (on vacation, temporarily ill, on
maternity leave, etc.), answer “Yes”.
□ No
GO TO question 56.
□
□
□
53. For the job or business you were in last week,
were you a member of a labor union or of an
employee association similar to a union (for
example, AFL-CIO, Change to Win Federation,
NEA)?
□
No
Yes
I worked at a full-time
job (job of 35 hours or
more per week)
I worked at one or more part-time jobs
(no full-time job)
No
Yes
Never worked
for pay
GO TO question
73 on page 23.
□
Over 12 months
ago
GO TO question
63 on page 22.
□
Within the past
12 months
□
□
□
□
□
□
GO TO question 60.
50 to 52 weeks
48 to 49 weeks
40 to 47 weeks
27 to 39 weeks
14 to 26 weeks
13 weeks or less
61. During the past 12 months, in the weeks you
worked, how many hours did you usually work
each WEEK?
56. Last week, were you on layoff from a job?
□
□
□
60. During the past 12 months (52 weeks), how
many weeks did you work, including paid
vacation, paid sick leave, and military service?
(Mark one.)
GO TO
question 60.
55. Would you have preferred to work at a fulltime job?
□
□
No
Yes
I don’t know
59. When did you last work, even for a few days?
54. Which one of the following best describes your
employment situation last week? (Mark one.)
□
GO TO question 59.
58. Do you intend to look for work within the next
5 years?
□ Yes
□
□
No
Yes
No
Yes
Usual hours worked each WEEK:
21
64. For whom did you work?
62. Which category best fits your earnings from
wages, salary, commissions, bonuses or tips,
from all jobs over the past 12 months? (Mark
one.)
□
Report amount before deductions for taxes,
bonds, dues, or other items.
□
□
□
□
□
□
□
□
□
$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $75,000
$75,001 to $150,000
$150,001 or more
If now on active duty in the Armed
Forces, mark (X) this box and print the
branch of the Armed Forces below. All
others, enter name of company,
business, or other employer below.
Name of company, business, or other
employer:
65. What kind of business or industry was this?
(For example: hospital, newspaper publishing,
mail order house, auto engine manufacturing,
bank)
63. For the next few questions, please describe
your chief job activity or business last week.
If you had more than one job, describe the one
at which you worked the most hours. If you had
no job or business last week, give information
for your last job or business.
66. What kind of work were you doing?
In your current or last job, which one of the
following were you? (Mark one.)
□
□
□
□
□
□
□
(For example: registered nurse, personnel
manager, supervisor of order department,
secretary, accountant)
An employee of a private for-profit
company or business, or of an
individual, for wages, salary, or
commissions
An employee of a private not-for-profit,
tax-exempt, or charitable organization
A local government employee (city,
county, etc.)
A state government employee
A Federal government employee
Self-employed in own business,
professional practice, or farm
Working without pay in family business
or farm
67. What were your most important activities or
duties?
(For example: patient care, directing hiring
policies, supervising order clerks, typing and
filing, reconciling financial records)
22
68. What kind of position did you hold? (Mark
one.)
□
□
□
Background
73. Have you ever served on active duty in the U.S.
Armed Forces, Reserves, or National Guard?
(Mark one.)
GO TO
Permanent
question 70.
Temporary with
no set end date
Temporary with set end date
□
GO TO
No, never served
question 75.
in the military
□ Yes, but only on active duty
for training in the Reserve or
National Guard
□ Yes, on active duty now or in past
69. Would you have preferred to work at a
permanent job?
□
□
No
Yes
74. Have you served on active duty since
September 2001?
70. How many people worked for your employer?
Count employees at all locations. (Mark one.)
□ No
□ Yes
75. Do you speak a language other than English at
home?
If you were self-employed, how many people
worked for you, including yourself?
□
□
□
□
1—49 people
50—499 people
500—999 people
1,000 or more people
71. How supportive was your employer of your
training needs? (Mark one.)
□
□
□
□
□
No
□
Yes
GO TO question 77.
76. How well do you speak English? (Mark one.)
□
□
□
□
Not at all supportive
Somewhat supportive
Very supportive
Not applicable
Very well
Well
Not well
Not at all
77. Are you male or female?
72. When you started your current job, did it have
a clear training path laid out, or did you need
to figure out on your own what training you
needed? (Mark one.)
□
□
□
□
□
Male
Female
78. How old are you?
A clear training path was laid out
Some parts of the training path
were clear
I needed to figure it out on my own
years old
79. Are you of Hispanic or Latino origin?
□
□
23
No
Yes
80. What is your race? Choose one or more.
□
□
□
□
□
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
81. What is your current marital or partner status?
(Mark one.)
□
□
□
□
□
Married
In a registered domestic partnership or
civil union
Living with a partner
Widowed, divorced, or separated
Never married
Thank You.
Please return this questionnaire in the postagepaid envelope provided. If you have lost the
envelope, mail the completed questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
24
Commonly Asked Questions
Q: How was my household chosen?
A: You were randomly selected from lists of people who have obtained work-related credentials. The sample
was designed to represent people who have many different kinds of education, training, and jobs. Even if
you don’t currently have a work-related credential or aren’t currently working, it’s still important that you
participate so all kinds of people are represented.
Q: Why should I participate? Do I have to do this?
A: Your answers are very important to the success of this study. You represent other adults like yourself, and
you cannot be replaced. This survey is voluntary. You may choose not to answer any or all questions in
this survey, but in order for the survey to be representative, it is important that you complete and return it.
Those who do not return the survey will not be represented in statistics used by policymakers and
researchers. There are no penalties should you choose not to participate in the study.
Q: Will the information I provide be kept confidential? Will my privacy be protected?
A: Yes. Your responses will be combined with those from other adults to produce statistical summaries about
education and training in the United States. Your individual data will not be reported. Your answers may
be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other
purpose except as required by law (20 USC § 9573).
Q: How will my response help the Federal Government?
A: The U.S. Departments of Education and Labor want to understand how adults acquire and maintain the
skills they need for work. This survey is the only way these Departments can learn about the education
and training that adults receive from schools, employers, and other training sponsors. The survey will
allow policymakers and researchers to better understand the demand for education and training programs,
and can help direct national policy in these areas. Your responses will be combined with others to inform
educators, policy makers, and schools about how adults in the U.S. learn the skills needed for work.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics (NCES), within the U.S. Department of Education, is
authorized to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this survey on
behalf of NCES. This study has been approved by the Office of Management and Budget (OMB), the
office that reviews all federally sponsored surveys. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. The OMB approval number assigned to this study is 1850-0803. You may send any comments
about this survey, including its length, to the Federal Government. Write to: Lisa Hudson, National Center
for Education Statistics, U.S. Department of Education, 1990 K Street NW, Washington, DC 20006-5650.
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to xxxx@census.gov or you may call the
Census Bureau toll-free at 1-800-xxx-xxxx.
25
C.4 CWS for seeded sample
OMB No. 1850-0803: Approval Expires 09/30/2016
Credentials for Work Survey
Part of the 2014 National Household Education Survey
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this next step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
2
Instructions
These questions should be filled out by:
No one else in the household should fill out the survey.
To answer a question, simply mark the box [X] that best represents your
answer.
Use a black or blue pen, if available, to complete this survey.
Please return the completed survey using the postage-paid envelope
provided.
If you have any questions about this survey, please call us at our tollfree number: 1-888-xxx-xxxx.
We are authorized to collect this information by U.S. Code, Title 20, Section 9543. You do not have to provide
the information requested. However, the information you provide will help the Department of Education’s
ongoing efforts to learn more about the educational experiences of adults. There are no penalties should you
choose not to participate in this study. Your answers may be used only for statistical purposes and may not be
disclosed, or used, in identifiable form for any other purpose except as required by law (U.S. Code, Title 20,
Section 9573). Your responses will be combined with those from other participants to produce summary
statistics and reports.
Depending on your background, this survey is estimated to take 10 to 20 minutes, including time for reviewing
instructions and completing the survey. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: Lisa Hudson, National Center for Education Statistics, U.S.
Department of Education, 1990 K Street NW, Washington, DC 20006-5650. Do not return the completed form
to this address.
3
Educational Attainment
Certification and Licensure
1. What is the highest degree or level of school
you have completed? (Mark one.)
3. Do you have a currently active professional
certification or a state or industry license? Do
not include business licenses, such as a liquor
license or vending license.
□ Elementary or high school,
but no high school diploma or GED
□ High school diploma
GO TO
question 3.
□ GED, or alternative credential
□ Some college credit but less
than one year of college credit
A professional certification or license shows you
are qualified to perform a specific job and includes
things like Licensed Realtor, Certified Medical
Assistant, Certified Construction Manager, or an IT
certification.
□ No
□ 1 or more years of college credit,
no degree
GO TO question 10 on page 10.
□ Yes
□ Associate’s degree (for example, AA, AS)
□ Bachelor’s degree (for example, BA, BS)
4. How many certifications and licenses do
you have?
□ Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)
If you had to get a certification in order to
get a license, count each certification and
license separately.
□ Professional degree beyond a bachelor’s
degree (for example, MD, DDS, DVM, LLB,
JD)
Number of certifications and licenses:
□ Doctorate degree (for example, PhD, EdD)
CONTINUE on page 6.
2. Using Table A on page 5, what was the major
or field of study for your highest level of
education?
If there was more than one, please choose the
one you consider most important.
Number from Table A on page 5:
4
TABLE A. FIELD OF STUDY CODES FOR QUESTION 2
1
Accounting, finance, insurance, or real
estate
21 Law enforcement, security, or
firefighting
2
Administrative support
22 Journalism or communications
3
Agriculture
23 Law or legal studies
4
Architecture
24 Leisure or fitness studies
5
Arts, music, or design
25 Liberal arts
6
Biological/biomedical sciences
26 Library science
7
8
Business management or marketing
Communications technologies (e.g.,
printing, broadcasting, recording, and
graphics technologies)
27 Manufacturing or production (e.g.,
machinist, welder, boilermaker)
9
28 Mathematics or statistics
29 Mechanic or repair technologies
Computer and information sciences
30 Military science/technologies
10 Construction trades
31 Natural resources or conservation
11 Cosmetology or barbering
32 Philosophy or comparative religions
12 Culinary arts
33 Physical sciences
13 Drafting, engineering technologies, or
science technologies
34 Psychology
35 Religious vocations or theology
14 Education
36 Social or human services or public
administration
15 Engineering
16 English language/literature
37 Social sciences (e.g., anthropology,
gender or ethnic studies) or history
17 Family and consumer sciences
18 Foreign languages
38 Transportation or materials moving
39 Interdisciplinary
19 Funeral/mortuary services
20 Healthcare professions
5
5. Please fill out a column in the following grid for each currently active certification and license you have,
up to three.
If you have more than three, answer for the three you last earned or renewed.
Certification or License
#1
Certification or License
#2
Certification or License
#3
5a. In your own words, what is
the name of the
certification or license?
5b. Using Table B on page 7,
what is its subject field?
Number
from Table B:
Number
from Table B:
Number
from Table B:
5c. Could you use it to get a
job with another employer
in that field?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
□ I don’t know
□ I don’t know
□ I don’t know
5d. Did you have to pass a test,
submit a portfolio, or
demonstrate your skills to
get it?
□ No
□ Yes
□ No
□ Yes
□ No
□ Yes
5e. Was it awarded by the
federal, state, or local
government?
□ No
□ No
□ No
□ Yes
□ Yes
□ Yes
□ I don’t know
□ I don’t know
□ I don’t know
□ No
□ No
□ No
□ Yes, and it is
□ Yes, and it is
□ Yes, and it is
required
required
required
(For example, by a state
board of education or other
state board, OSHA, or FAA)
5f. Is it for your current job?
(Mark one.)
□ Yes, but it is not
□ Yes, but it is not
required
5g. In what year did you last
earn or renew it?
□ Yes, but it is not
required
Year:
Year:
6
required
Year:
TABLE B. FIELD OF CERTIFICATION OR LICENSE CODES FOR QUESTION 5b
1
EMT, CPR, or basic first aid
11 Law or legal support
2
Other health care (for fitness use code 13)
Includes health-care technologist or
technician; health-care therapist (for
counseling use code 17); nursing
occupations, medical practitioners (such as
MD, OD, PA, DC, PharmD, DVM), and healthcare specialties such as ACLS.
12 Notary public
3
Architecture, engineering, or energy
Includes architecture, drafting, engineering,
engineering technologies, LEED, energy
auditing and other similar fields.
4
Business management, operations, and
support
Includes project management, Six Sigma,
Lean Manufacturing, and other business
management, support, and operations.
5
Childcare
6
Cosmetology or barbering
7
Finance, insurance, or real estate
Includes insurance, real estate, taxes
and accounting, and other finance (for
notary public use code 12).
8
9
13 Physical fitness
Includes personal or athletic trainer,
yoga instructor, and other fitness
instruction.
14 Public safety
Includes law enforcement, firefighting,
flight attendant, and other public safety
services (for water and hazardous waste
treatment use code 8).
15 Religious ordination
16 Skilled trades
Includes automotive repair, HVAC
installation and repair, construction trades
(carpenter, electrician, mason, plumber),
welder, and machining or equipment
operator (such as boiler, crane, or forklift
operator).
17 Social work or counseling
18 Teaching (public or private schools)
Includes preschool through grade 12
teaching. (For other instructional fields, use
the code for that field; for example, flight
instructors use code 19 for transportation.)
Food handling and sanitation
Includes food handling, water treatment and
sanitation, hazardous waste operations, and
other food handling and sanitation fields.
19 Transportation
Includes CDL, aviation or marine piloting,
and other transportation work (for flight
attendant use code 14).
Funeral, mortuary, and taxidermy
10 Information technology
Includes software development and
applications, networking, hardware, and
other computer and information
technologies.
20 Other fields not listed above
7
The rest of this section asks about the
certification or license you last earned or
renewed – that is, the one with the most
recent year in question 5g on page 5.
7. Which of the following prepared you to earn this
certification or license? (Mark ALL that apply.)
□ I earned a college degree.
□ I took other classes from a college,
6. How useful has your last certification or
license been for each of the following?
□
a. Getting a job. (Mark one.)
□
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
technical school, or trade school.
I took classes or training from a company,
association, union, or private instructor.
I studied on my own using textbooks or
on-line resources.
I participated in on-the-job training, an
internship, or apprenticeship.
I did not take any classes, training, or
instruction.
b. Keeping a job. (Mark one.)
□
□
□
□
8. How often do you have to renew this
certification or license? (Mark one.)
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
□
□
□
□
c. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
□ Renew it
□ Let it expire
□ I don’t know
Too soon to tell
Not useful
Somewhat useful
Very useful
CONTINUE on page 10.
e. Improving your job skills. (Mark one.)
□
□
□
□
GO TO
question 10
on page 10.
9. What do you plan to do the next time this
certification or license is up for renewal? (Mark
one.)
d. Keeping you marketable to employers or
clients. (Mark one.)
□
□
□
□
I do not have to renew it
Once a year
Every 2 years
Every 3 years
Every 4 years
Every 5 or more years
Too soon to tell
Not useful
Somewhat useful
Very useful
8
This page left blank intentionally.
9
14. Did you get this educational certificate in order
to earn a professional certification or license?
Educational Certificates
□ No
10. After leaving high school, some people take
classes at a college, technical school, or trade
school to earn an educational certificate.
□ Yes
This educational certificate is sometimes called a
diploma, for example a cosmetology diploma.
But it is not a high school diploma. It is also not a
college degree or a professional certification.
15. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
An educational certificate is awarded only by
schools.
□ Not at all
□ Somewhat
□ A great deal
Have you ever earned this type of educational
certificate?
□
No
□
Yes
16. What type of school awarded this educational
certificate? (Mark one.)
GO TO question 26 on page 13.
□ Trade or vocational school; community
or technical college
The next few questions ask about your last
educational certificate.
□ Other college or university
□ Other type of school (specify)
11. About how many hours of instruction did you
complete in order to earn your last educational
certificate? (Mark one.)
17. Was this educational certificate earned as part
of a bachelor’s or master’s degree, or as an
add-on to a degree?
□ 160 or more hours (4 or more full-time
weeks)
□ 40-159 hours (1 week to less than four
full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
□ No
□ Yes
18. Do you have another educational certificate?
12. Using Table C on page 11, what was the field of
study for this educational certificate?
Number from Table C:
□
No
□
Yes
CONTINUE
ON page 12.
13. In what year did you get this educational
certificate?
Year:
10
GO TO question 26 on page 13.
TABLE C. FIELD OF STUDY CODES FOR QUESTIONS 12 AND 20
1
2
3
4
5
6
7
8
9
Accounting, finance, insurance, or
real estate
Administrative support
Arts, music, or design
Business management or
marketing
Communications technologies (e.g.
printing, broadcasting, recording,
and graphics technologies)
Computer and information sciences
Construction trades
Cosmetology or barbering
Culinary arts
10
11
12
13
14
15
16
17
18
19
20
11
Drafting, engineering technologies, or
science technologies
Education
Funeral/mortuary services
Healthcare professions
Law enforcement, security, or firefighting
Legal studies
Manufacturing or production (e.g.,
machinist, welder, boilermaker)
Mechanic or repair technologies
Religious vocations or theology
Transportation or materials moving
Other field of study not listed above
The next few questions ask about your next-to-last
educational certificate.
24. What type of school awarded this educational
certificate? (Mark one.)
19. Thinking about your next-to-last educational
certificate, about how many hours of
instruction did you complete in order to earn
it? (Mark one.)
□ Trade or vocational school; community or
technical college
□ Other college or university
□ Other type of school (specify)
□ 160 or more hours (4 or more full-time
weeks)
□ 40-159 hours (1 full-time week to less
than four full-time weeks)
□ Less than 40 hours (less than 1 full-time
week)
25. Was this educational certificate earned as part
of a bachelor’s or master’s degree, or as an
add-on to a degree?
□ No
20. Using Table C on page 11, what was the field of
study for this educational certificate?
□ Yes
Number from Table C:
21. In what year did you get this educational
certificate?
Year:
22. Did you get this educational certificate in order
to earn a professional certification or license?
□ No
□ Yes
23. To what extent is this educational certificate
related to your current job? (Mark one.)
If you are not employed, answer “not at all.”
□ Not at all
□ Somewhat
□ A great deal
12
30. As part of this apprenticeship, did you take any
formal classes? Include any classes taken inperson or on-line. (Mark all that apply.)
Apprenticeships
26. Have you ever completed an apprenticeship?
□ No
□ Yes, from an employer or union
□ Yes, from a community or technical college
Do not count student teaching, medical
internships or residency, externships, or unpaid
internships.
□
No
□
Yes
or other college
□ Yes, from another organization
GO TO question 36 on page 14.
31. What wage did you earn during this
apprenticeship program? (Mark one.)
The rest of this section asks about the last
apprenticeship you completed.
□ No wage
□ A low starting wage that increased as you
27. Who sponsored the apprenticeship? (Mark
one.)
□
□
□
□
□
□
□
became more qualified during the
apprenticeship
□ A low starting wage that increased only
when I became fully qualified at the end of
the apprenticeship
□ The same wage as a fully qualified worker
The U.S. military
Federal civilian government
State or local government
A (non-military) employer
An employer-union partnership
Other sponsor
I don’t know
32. What type of occupation was this
apprenticeship for? (Mark one.)
□
□
□
□
□
□
□
□
□
□
□
□
□
28. Did this apprenticeship lead to a Certificate of
Completion of Apprenticeship from your state
or from the U.S. government?
□
□
□
No
Yes
I don’t know
29. How long did this apprenticeship last? (Mark
one.)
□
□
□
□
□
Less than 1 year
1 year
2 years
3 years
4 years or more
13
Construction trades
Driving or transport
Engineering or architecture
Food preparation
Health care
Information technology (IT)
Management
Manufacturing, printing, or production
Mechanic, installation, or repair
Public safety or corrections
Real estate, finance, or insurance
Other sales or customer service
Other (specify)
College Classes
33. How useful was your apprenticeship for each of
the following?
36. How many college classes have you taken in
the past 12 months?
a. Getting a job. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
Count only classes you completed or are
currently taking.
□ I have not taken any
b. Increasing your pay. (Mark one.)
□
□
□
□
Too soon to tell
Not useful
Somewhat useful
Very useful
Number of college classes:
37. How many of these classes were not for college
credit (that is, non-credit)?
Count only classes you completed within the
past 12 months or are currently taking.
c. Improving your job skills. (Mark one.)
□
□
□
□
GO TO question
39 on page 15.
college classes in the
past 12 months.
Too soon to tell
Not useful
Somewhat useful
Very useful
□
□
□
□
□
34. Are you currently working in the occupation
that you apprenticed in?
I don’t know
None
One
Two
Three or more
GO TO question 39 on
page 15.
38. Thinking of the last non-credit class you took,
which of the following describe why you took
this class? (Mark all that apply.)
□ No
□ Yes
□ To prepare for or to consider further
35. In your current job, how often do you use the
skills that you learned in your apprenticeship?
□
□
If you are not employed, please answer “Never
or almost never”.
□
□
□ Never or almost never
□ Sometimes
□ All or most of the time
14
education
For personal interest
To earn, maintain, or renew a
professional certification or license
For my current job
For another work-related reason
Training for Work
Employment
39. People often participate in courses, training, or
other instruction for work.
41. Last week, were you employed for pay at a job
or business?
These trainings can include classes, seminars, or
workshops. They can be taken at the workplace,
on-line, or somewhere else, and can include
topics such as:
If you were temporarily absent from a job or
business (on vacation, temporarily ill, on
maternity leave, etc.), answer “Yes”.
□ No
Job safety, work ethics or other
regulations,
Equipment use,
Communication, sensitivity, or teambuilding,
Computer or technical skills,
Management skills, and
Other job skills.
□ Yes
42. Which one of the following best describes your
employment situation last week? (Mark one.)
□
OTHER THAN COLLEGE CLASSES YOU MAY
HAVE DESCRIBED EARLIER, have you completed
any work-related training in the past 12
months?
□
No
□
Yes
GO TO question 44.
□
GO TO
I worked at a full-time
question 48
job (job of 35 hours or
on page 16.
more per week)
I worked at one or more part-time jobs
(no full-time job)
43. Would you have preferred to work at a fulltime job?
GO TO question 41.
□
□
40. How many work-related trainings have you
completed in the past 12 months?
No
Yes
GO TO question 48 on page 16.
44. Last week, were you on layoff from a job?
□
□
Count multiple sessions of the same training as
one training.
No
Yes
45. During the last 4 weeks, have you been actively
looking for work?
Number of trainings:
□
□
No
Yes
GO TO question 47 on page 16.
46. Do you intend to look for work within the next
5 years?
□
□
□
15
No
Yes
I don’t know
47. When did you last work, even for a few days?
□
Never worked
for pay
□
Over 12 months
ago
□
Within the past
12 months
51. For the next few questions, please describe
your chief job activity or business last week.
GO TO question
58 on page 17.
If you had more than one job, describe the one
at which you worked the most hours. If you had
no job or business last week, give information
for your last job or business.
GO TO question 51.
In your current or last job, which one of the
following were you? (Mark one.)
□
48. During the past 12 months (52 weeks), how
many weeks did you work, including paid
vacation, paid sick leave, and military service?
(Mark one.)
□
□
□
□
□
□
□
50 to 52 weeks
48 to 49 weeks
40 to 47 weeks
27 to 39 weeks
14 to 26 weeks
13 weeks or less
□
□
□
□
49. During the past 12 months, in the weeks you
worked, how many hours did you usually work
each WEEK?
□
Usual hours worked each WEEK:
52. For whom did you work?
50. Which category best fits your earnings from
wages, salary, commissions, bonuses or tips,
from all jobs over the past 12 months? (Mark
one.)
□
Report amount before deductions for taxes,
bonds, dues, or other items.
□
□
□
□
□
□
□
□
□
An employee of a private for-profit
company or business, or of an
individual, for wages, salary, or
commissions
An employee of a private not-for-profit,
tax-exempt, or charitable organization
A local government employee (city,
county, etc.)
A state government employee
A Federal government employee
Self-employed in own business,
professional practice, or farm
Working without pay in family business
or farm
If now on active duty in the Armed
Forces, mark (X) this box and print the
branch of the Armed Forces below. All
others, enter name of company,
business, or other employer below.
Name of company, business, or other
employer:
$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $75,000
$75,001 to $150,000
$150,001 or more
16
53. What kind of business or industry was this?
Background
(For example: hospital, newspaper publishing,
mail order house, auto engine manufacturing,
bank)
58. Have you ever served on active duty in the U.S.
Armed Forces, Reserves, or National Guard?
(Mark one.)
GO TO
No, never served
question 60.
in the military
□ Yes, but only on active duty
for training in the Reserve or
National Guard
□ Yes, on active duty now or in past
□
54. What kind of work were you doing?
(For example: registered nurse, personnel
manager, supervisor of order department,
secretary, accountant)
59. Have you served on active duty since
September 2001?
□
□
No
Yes
60. Do you speak a language other than English at
home?
55. What were your most important activities or
duties?
□
□
(For example: patient care, directing hiring
policies, supervising order clerks, typing and
filing, reconciling financial records)
No
Yes
GO TO question 62.
61. How well do you speak English? (Mark one.)
□
□
□
□
56. What kind of position did you hold? (Mark
one.)
□
□
□
Very well
Well
Not well
Not at all
62. Are you male or female?
□
□
GO TO
Permanent
question 58.
Temporary with
no set end date
Temporary with set end date
Male
Female
63. How old are you?
years old
57. Would you have preferred to work at a
permanent job?
□
□
64. Are you of Hispanic or Latino origin?
No
Yes
□
□
17
No
Yes
65. What is your race? Choose one or more.
□
□
□
□
□
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
66. What is your current marital or partner status?
(Mark one.)
□
□
□
□
□
Married
In a registered domestic partnership or
civil union
Living with a partner
Widowed, divorced, or separated
Never married
Thank you.
Please return this questionnaire in the postage-paid
envelope provided. If you have lost the envelope,
mail the completed questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
18
Commonly Asked Questions
Q: How was I chosen?
A: You were randomly selected from lists of people who have obtained work-related credentials. The sample
was designed to represent people who have many different kinds of education, training, and jobs. Even if
you don’t currently have a work-related credential or aren’t currently working, it’s still important that you
participate so all kinds of people are represented.
Q: Why should I participate? Do I have to do this?
A: Your answers are very important to the success of this study. You represent other adults like yourself, and
you cannot be replaced. This survey is voluntary. You may choose not to answer any or all questions in
this survey, but in order for the survey to be representative, it is important that you complete and return it.
Those who do not return the survey will not be represented in statistics used by policymakers and
researchers. There are no penalties should you choose not to participate in the study.
Q: Will the information I provide be kept confidential? Will my privacy be protected?
A: Yes. Your responses will be combined with those from other adults to produce statistical summaries about
education and training in the United States. Your individual data will not be reported. Your answers may
be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other
purpose except as required by law (20 USC § 9573).
Q: How will my response help the Federal Government?
A: The U.S. Departments of Education and Labor want to understand how adults acquire and maintain the
skills they need for work. This survey is the only way these Departments can learn about the education
and training that adults receive from schools, employers, and other training sponsors. The survey will
allow policymakers and researchers to better understand the demand for education and training programs,
and can help direct national policy in these areas. Your responses will be combined with others to inform
educators, policy makers, and schools about how adults in the U.S. learn the skills needed for work.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics (NCES), within the U.S. Department of Education, is
authorized to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this survey on
behalf of NCES. This study has been approved by the Office of Management and Budget (OMB), the
office that reviews all federally sponsored surveys. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a currently valid OMB control
number. The OMB approval number assigned to this study is 1850-0803. You may send any comments
about this survey, including its length, to the Federal Government. Write to: Lisa Hudson, National Center
for Education Statistics, U.S. Department of Education, 1990 K Street NW, Washington, DC 20006-5650.
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to xxxx@census.gov or you may call the
Census Bureau toll-free at 1-800-xxx-xxxx.
19
C.5 After-School Programs and Activities Survey (ASPA) version A
Version A
OMB No. 1850-0803: Approval Expires 9/30/2016
The National Household Education Survey
A Survey about Students’ After-School Activities
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
Version A
Instructions
In response to the survey you answered earlier, we recorded that the
child/youth listed below attends school. If this child is homeschooled
instead of attending public or private school, or if this child has not yet
started kindergarten, please call us at the toll-free number below so we can
be sure you received the correct survey.
These questions should be filled in by a parent or guardian who knows
about:
Please answer all the survey questions thinking about this child or youth.
the box that best represents your
To answer a question, simply mark
answer.
Please use a black or blue pen, if available, to complete this survey.
If this questionnaire has been sent to the wrong household or the
child/youth listed above does not live here, please call to let us know.
Our toll-free number is 1-888-XXX-XXXX.
We are authorized to collect this information by Section 9543, 20 U.S. Code. You do not have to provide
the information requested. However, the information you provide will help the Department of Education’s
ongoing efforts to learn more about the educational experiences of children and families. There are no
penalties should you choose not to participate in this study. Your answers may be used only for statistical
purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required
by law (Section 9573, 20 U.S. Code). Your responses will be combined with those from other participants
to produce summary statistics and reports.
This survey is estimated to take an average of 20 minutes, including time for reviewing instructions, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: Sarah Carroll, National Center for
Education Statistics, U.S. Department of Education, 1990 K Street NW, Washington, DC 20006-5650. Do
not return the completed form to this address.
Version A
1. Child’s Schooling
5. Is this school a charter school?
► Thank you for your help with the
previous survey your household
completed.
► Answer all the survey questions
thinking about the child listed below:
■ No
■ Yes
6. How much do you agree or disagree with
the following statement:
“This child enjoys school.”
■ Strongly agree
■ Agree
■ Disagree
■ Strongly disagree
1. What is this child’s current grade or
year of school?
If this child is not assigned a specific grade,
mark or write the grade he/she would be in at
a school with regular grades.
■ Child has not yet started kindergarten
7. Please tell us about this child’s grades
during this school year. Overall, across all
subjects, what grades does this child get?
Please STOP now and call
1-888-XXX-XXXX.
■ Mostly A’s
■ Mostly B’s
■ Mostly C’s
■ Mostly D’s and lower
■ This child’s school does not give these
■ Full-day kindergarten
■ Partial-day kindergarten
grade (1 through 12)
2. Is this child homeschooled instead of
going to a public or private school for
some classes or subjects?
■ No
■ Yes –
grades
8. Since the beginning of this school year, how
many times have any of this child’s teachers
or school staff contacted your household
about…
For how many hours
each week does this child attend
a public or private school?
Write ‘0’ if none.
Number
3. What type of school does this child attend?
■ Private, Catholic
■ Private, religious
but not Catholic
a. Behavior problems this child is
having in school ............................
b. Problems this child is having with
school work ....................................
GO TO question 6
■ Private, not religious
■ Public school
c. Very good behavior .....................
d. Very good school work ................
4. Is it his/her regularly assigned school?
■ No
■ Yes
3
Version A
9.
12. Has this child ever had the following
experiences?
Since the beginning of this school year,
how many days has this child been
absent from school?
Mark
ONE box for each item below.
days
No Yes
▼
10. Since starting kindergarten, has this child
repeated any grades?
■ No
■ Yes
▼
a. An out-of-school suspension .........
b. An in-school suspension not
counting detentions .......................
GO TO question 12
c. Been expelled from school ............
11. What grade or grades did he/she repeat?
Mark
13. How far do you expect this child to go in
his/her education?
all that apply.
Elementary through Middle school
■ Kindergarten
■ First grade
■ Second grade
■ Third grade
■ Fourth grade
■ Fifth grade
■ Sixth grade
■ Seventh grade
■ Eighth grade
Mark
ONE only.
■ Complete less than a high school diploma
■ Graduate from high school
■ Attend a vocational or technical school
after high school
■ Attend two or more years of college
■ Earn a bachelor’s degree
■ Earn a graduate degree or professional
degree beyond a bachelor's
14. How would you describe his/her work at
school?
High school
■ Ninth grade - freshman
■ Tenth grade - sophomore
■ Eleventh grade - junior
■ Twelfth grade - senior
Mark
ONE only.
■ Excellent
■ Above average
■ Average
■ Below average
■ Failing
4
Version A
2. Choosing After-School
Arrangements
18. How satisfied are you with the actual afterschool care, programs, and activities
available to you in your community?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisified
Children spend their after-school time in many
different ways. Some children are with parents or
relatives after-school, some care for themselves,
and others attend a supervised care program or
participate in clubs, lessons, sports or other
organized activities. After-school hours are the
hours after the child is finished with school before
8pm.
19. Is this child’s parent with him or her each
day when this child finishes school until
8pm?
These next questions ask about what is important
to your family when deciding how this child
spends his or her time after-school.
■ No
■ Yes
15. Do you feel there are good choices for
after-school care, programs, or activities
where you live?
20. Not counting times when an adult is at
home and this child is outside playing, is
this child responsible for him or herself
each day for 30 minutes or more after
school?
■ No
■ Yes
■ Don’t know
■ No
■ Yes
16. Does your child’s school or your local
community provide information about
after-school care, programs, or activities
where you live?
21. This school year, does this child attend a
supervised care program, or participate in
clubs, lessons, sports or other organized
activities during after-school hours?
■ No
■ Yes
■ Don’t know
■ No
■ Yes
17. Have you looked for information about
after-school care, programs, or activities
for your child?
GO TO question 25
Continue with question 22 on the
next page.
■ No
■ Yes
5
Version A
22. How important was each of the following reasons when your family was making decisions about
where this child spends after-school hours until 8pm?
Mark
ONE box for each line.
Not at all
important
A little
important
a. A convenient location……..………….
b. Cost.…………………….………………
c. Adult supervision...................................
d. A safe environment...............................
e. A nurturing environment……...……...
f. Child is cared for by someone your
family knows…………..……………………
g. Transportation to and from the care,
program, or activity……………………......
h. All of your children can be at the same
place…………………………………………
i. The hours and schedule are convenient
j. Quality of facilities…………….……..
k. The provider is licensed or accredited.
l. Ability of someone to speak child or
family’s first language…………….............
m. Ability of someone to care for child’s
special needs…………….........................
n. Adequate number of staff………….....
o. No other care/programs available..…..
6
Somewhat
important
Very
important
Not
applicable
Version A
23. Other than the reasons on the previous page, how important was each of the following reasons
when your family was making decisions about where this child spends after-school hours until 8pm?
Mark
ONE box for each line.
Not at all
important
A little
important
Somewhat
important
Very
important
Not
applicable
a. Child enjoys it …………………………...
b. Child spends time with other kids
his/her age………………...……………...
c. Child spends time with family…..……
d. Cultural diversity of the children……..
e. Provides music, art, and culture..…….
f. Provides access to computers ……….
g. Provides math and science activities …
h. Provides academic support/tutoring…..
i. Provides help for this child to learn
English…………...……………….…..…..
j. Provides help for this child to learn
another language…………………………
k. Provides reading activities…………..…
l. Provides physical activities…………..….
m. Provides mentors or role models…..…
n. You or your family like the staff…….….
o. Religious affiliation of program…...…..
24. Other than the reasons listed above, were there any other reasons your family considered when
making decisions about where this child spends after-school hours until 8pm?
7
Version A
25. Last week, where was this child during after school hours until 8pm?
For each day of the week below, mark
the box that corresponds to the location where this child spent at least 30
minutes after school hours. Mark all that apply.
If last week this child missed his or her regular activities, please answer about the most recent typical week.
Child spends at least 30
minutes…
a. At this child's home
Monday
□
□
Tuesday Wednesday
Thursday
Friday
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
i. At a parent or guardian’s
workplace
□
□
□
□
□
j. At another location not listed,
specify: ___________________
□
□
□
□
□
b. At another home, including
relative or care provider’s home
c. At this child’s school
d. At a community center
e. At a day-care or after-school
care center located in its own
building
f. At a college or university
g. At a library
h. At a church, synagogue,
temple, or other place of
worship
8
□
□
□
□
Version A
26. Last week, who looked after this child during after school hours until 8pm?
For each day of the week, mark
the box with the individual who typically looked after this child after school for at least 30
minutes. Mark all that apply.
If last week this child missed his or her regular activities, please answer about the most recent typical week.
Child spends at least 30 minutes with…
a. Mother (birth, adoptive, step, or foster)
Monday Tuesday
Wednesday
Thursday
Friday
□
□
g. Child takes care of him/herself for more
than 30 minutes
□
□
□
□
□
□
□
□
□
□
□
□
□
□
h. A nanny, babysitter, or another person
not related to the child
□
□
□
i. An adult staff person at a formal afterschool program or center
□
□
□
□
□
j. An adult at an organized club, sports or
activity (e.g., coach, art teacher)
□
□
□
□
□
b. Father (birth, adoptive, step, or foster)
c. Grandmother or grandfather
d. Aunt or uncle
e. Brother or sister
f. Another relative not listed
9
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Version A
27. Last week, which of the following activities did this child do during after school hours until 8pm, if any?
For each day of the week, mark
the box if this child typically participated in the listed activity. Mark all that apply.
If last week this child missed his or her regular activities, please answer about the most recent typical week.
Monday
Wednesday
Thursday
Friday
d. Mathematics, like math labs or
math clubs
□
□
□
□
Tuesday
e. Science, like science labs or
science clubs
□
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g. Music, like lessons, band, or
chorus
□
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h. Arts, like drawing, painting,
performing, or dance lessons
□
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i. School clubs, like yearbook,
chess or debate team
□
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j. Community activities, like 4-H
and Scouts
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a. Homework
b. Receiving tutoring
c. Reading or writing for fun
f. Engineering or technology, like
computer programming or
robotics
k. Volunteering
l. A religious activity
□
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10
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Version A
28. Last week, which of the following activities did this child do during after school hours until 8pm, if any?
For each day of the week, mark
the box if this child typically participated in the listed activity. Mark all that apply.
If last week this child missed his or her regular activities, please answer about the most recent typical week.
a. Sports (team or individual)
b. Physical activities, like
jumping rope, biking, dancing
c. Other playing outdoors
d. Playing indoors, like playing
board games and playing with
toys inside
e. Socializing with friends
f. Watching TV or movies
(includes things like, online
streaming, Netflix, VHS, DVD, or
Blu-ray)
g. Playing video games, like
computer games and games for
Xbox, Wii, and PlayStation
h. Using a smartphone,
computer, or tablet, for
Facebook, Twitter, Instagram, or
Internet browsing (Does not
include computer games and
homework)
i. Working at a job
j. Chores
k. Taking care of a sibling
l. Another activity not listed,
Specify:
Monday
Tuesday
Wednesday
Thursday
Friday
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11
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Version A
32. If you answered No to question 29, GO TO question
47, otherwise continue with question 33.
3. Formal After-School
Programs
33. How many different formal after-school
programs does this child attend?
■ One
■ Two
■ Three or more
The Department of Education would like to know
more information about formal after-school
programs that children attend. These are
programs that provide supervision and structured
activities. These programs are usually held in a
school or a center, and are different from
individual activities like sports, scouts, clubs, or
special lessons.
34. How many hours each week does this
child spend at formal after-school
program(s) or center(s) after school,
before 8pm?
29. Is this child now attending an after-school
program at a school or in a center, either
on a scheduled or a drop-in basis, at least
once each week?
■ No
■ Yes
hours each week
35. These next questions ask about the afterschool program where this child spends
the most time.
GO TO question 33
Is there any charge or fee for this program,
paid either by you or some other person or
agency?
30. In the past year, have you tried to enroll
this child in an after-school program either
at your child’s school or at another
location?
■ No
■ Yes
■ No
■ Yes
36. Do any of the following people,
programs, or organizations help pay for
this child to go to this program?
31. What is the main reason you did not enroll
this child in an after-school program in a
school or center?
Mark
ONE box
Mark
Child did not need to be in a program
Child was not eligible because of
ONE box for each item below.
No
▼
a. A friend or relative of this
child outside your household
who provides money
specifically for that program,
not including general child
support ...............................
grades
Child was not eligible because of age
Hours of the program(s) do not fit
family’s needs
Program(s) are too expensive
Program(s) were at capacity/full
Poor program quality
Staff does not speak child’s primary
GO TO question 39
GO TO
question
47
language
b. Temporary Assistance for
Needy Families, or TANF ...
c.
Another social service,
welfare, or child care agency
d. An employer, not including a
tax-free spending account
for child care .......................
Transportation was unavailable
Program(s) not available where I live
Other reason not to enroll this child
e. Someone else ....................
Specify: ______________________
12
Yes
▼
Version A
41. How would you rate the overall quality of
this program?
Best I can imagine
Better than I expected
Good
Not as good as I expected
Not good enough
■
■
■
■
■
37. How much does your household pay for
this child to go to this program, not
counting any money that you may receive
from others to help pay for care?
Write ‘0’ if your household does not pay for
this program.
$
42. How does this child get to the after-school
program?
■ Does not need transportation
■ Parent drives
■ Friend or relative drives
■ Activity bus
■ Public transportation
■ Other
Specify:
. .00
Is that amount per…
■ Hour
■ Day
■ Week
■ Month
■ Year
■ Every 2 weeks
■ Other
43. Is this program run by his or her
school?
■ No
■ Yes
Specify:
38. How many children from your household is
this amount for, including this child?
■ Do not pay for program
■ This child only
■ 2 children
■ 3 children
■ 4 children
■ 5 or more children
44. How many programs does this child
participate in that are run by his or her
school?
■ None
■ One
■ Two
■ Three or more
39. How many years/months has this child been
attending this program?
years
45. How many hours each weekend does this
child spend at formal after-school
program(s) or center(s)?
months
hours each weekend
46. Last summer, did this child participate
in
any
school
or
center-based
programs, at least once each week for
at least 4 weeks?
40. How often do you or another adult in
your family talk to a staff member at
this program?
■ Less than once a month
■ Once or twice a month
■ Once or twice a week
■ Three or more times a week
■ No
■ Yes
■ Don’t know or can’t remember
13
Version A
51. Do any of the following people, programs,
or organizations help pay for this child to
go to these activities?
4. Organized AfterSchool Activities
Mark
ONE box for each item below
No
▼
a. A friend or relative of this
child outside your household
who provides money
specifically for the activities,
not including general child
support .....................................
The following questions ask about organized
clubs or activities that this child might participate
in outside of school hours that are not part of a
formal after-school program. These might include
activities such as organized sports, music lessons,
scouts, or religious education.
47. Is this child participating in any organized
clubs or activities after school at least
once each week?
■ No
■ Yes
Yes
▼
b. Temporary Assistance for
Needy Families, or TANF .........
c. Another social service,
welfare, or child care agency ...
GO TO question 60
d. An employer, not including a
tax-free spending account for
child care ..................................
48. How many hours each week does this child
participate in activities or lessons afterschool, before 8pm?
e. Someone else ..........................
hours each week
52. How much does your household pay for
this child to participate in organized
activities, not counting any money that
you may receive from others to help pay
for the activities?
49. Does this child’s participation in these
activities help to cover the hours when you
need adult supervision for him/her?
■ No
■ Yes
Write ‘0’ if your household does not pay for
these activities.
50. Is there any charge or fee for these
activities, paid either by you or some other
person or agency?
■ No
■ Yes
$
. .00
Is that amount per…
■ Hour
■ Day
■ Week
■ Month
■ Year
■ Every 2 weeks
■ Other
GO TO question 54
14
Specify:
Version A
53 How many children from your household is
this amount for, including this child?
Do not pay for activities
This child only
2 children
3 children
4 children
5 or more children
58. How many hours each weekend does this
child participate in activities or lessons?
■
■
■
■
■
■
hours each weekend
59. Last summer, did this child participate
in any organized clubs or activities, at
least once each week for at least 4
weeks?
54. How many years/months has this child
been participating in organized activities
after-school?
years
■ No
■ Yes
■ Don’t know or can’t remember
months
55. How does this child get to the activities?
5. Other Arrangements
■ Does not need transportation
■ Parent drives
■ Friend or relative drives
■ Activity bus
■ Public transportation
■ Other
Specify:
60. How many hours each week is this
child looked after by a relative other
than
this
child’s
parent
(e.g.
grandparent, brother, sister, or other
relative) after school until 8pm?
Write 0 if child was not looked after by a
relative.
hours each week
56. How many activities does this child
participate in that are run by his or her
school?
■ None
■ One
■ Two
■ Three or more
61. How many hours each week is this
child responsible for himself/herself
for 30 minutes or more at a time after
school until 8pm?
Write 0 if child is never responsible for
him or herself for more than 30 minutes at
a time.
57. How often do you or another adult in your
family talk to a coach, supervisor, or staff
member at this child’s after-school
activities?
hours each week
62. How many hours each week is this
child looked after by a nanny,
babysitter, or another person not
related to the child, after school until
8pm?
■ Less than once a month
■ Once or twice a month
■ Once or twice a week
■ Three or more times a week
Write 0 if child was not looked after by
someone not related him or her.
hours each week
15
Version A
63. Last week, what time did this child’s
school day end?
:
■ AM
■ PM
64. Last week, what time was this child’s
bedtime during the school week?
:
■ AM
■ PM
16
Version A
6. Child’s Health
67. Did you mark any condition in question
66?
■ No
■ Yes
65. In general, how would you describe this
child’s health?
■ Excellent
■ Very good
■ Good
■ Fair
■ Poor
68. Is this child receiving services for his/her
condition?
■ No
■ Yes
GO TO question 74
69. Are any of these services provided through
an Individualized Education Program (IEP)?
66. Has a health or education professional told
you that this child has any of the following
conditions?
Mark
GO TO question 75
■ No
■ Yes
all that apply.
70. Are any of these services provided during
after-school hours?
A specific learning disability
■ No
■ Yes
An intellectual disability (mental
retardation)
A speech or language impairment
GO TO question 74
71. Who mainly provides services for this
child after-school?
A serious emotional disturbance
Mark
ONE box for each item below.
Deafness or another hearing impairment
No
▼
Blindness or another visual impairment
not corrected with glasses
a. Your local school district ..............
An orthopedic impairment
b. A state or local health or social
service agency .............................
Autism
Pervasive Developmental Disorder
(PDD)
c. A community center or
organization ..................................
Attention Deficit Disorder, ADD or
ADHD
c. A private doctor, clinic, or other
health care provider .....................
A developmental delay
Traumatic brain injury
Another health impairment lasting 6
months or more
17
Yes
▼
Version A
d. The service provider’s commitment to
help your child learn?
72. Where does this child typically receive
services during after-school hours?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
■ At this child’s home
■ At another private home
■ At this child’s school
■ At an after-school center
■ At a hospital, doctor’s office, or clinic
■ Someplace else
74. Does this child’s condition interfere with
his/her ability to do any of the following
things?
73. During this school year, how satisfied or
dissatisfied have you been with the
services this child receives during afterschool hours?
Mark
ONE box for each item below.
■ Child no longer has condition
a. The service provider’s communication
with your family?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
No
▼
a. Learn................................... .. ….
b. Participate in sports, clubs, or
other organized activities.........
c. Attend school on a regular
basis........................................
d. Make friends............................
b. The child’s service provider?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
► Continue with question 75 on the next
page.
c. The service provider’s ability to
accommodate the child’s special needs?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
18
Yes
▼
Version A
81. Does this child split his or her time between
two households, for example, because of a joint
custody arrangement?
7. Child’s Background
75. In what month and year was this child born?
Do not include vacation properties.
■ No
■ Yes
/
month
year
76. Where was this child born?
■ One of the 50 United States or the District
82. What language does this child speak most
at home?
of Columbia
Mark
GO TO question 78
ONE only.
■ Child is not able
■ One of the U.S. territories
to speak
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
GO TO question 84
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
■ Another country
77. How old was this child when he/she first
moved to the 50 United States or the
District of Columbia?
age
83. Is this child currently enrolled in English
as a second language, bilingual education,
or an English immersion program?
78. Is this child of Spanish, Hispanic, or Latino
origin?
■ No
■ Yes
■ No
■ Yes
► Continue with section 8, on the next page.
79. What is this child’s race? You may mark
one or more races.
■ American Indian or Alaska Native
■ Asian
■ Black or African American
■ Native Hawaiian or other Pacific Islander
■ White
80. What is this child’s sex?
■ Male
■ Female
19
Version A
8. Child’s Family
88. Is this person currently in a registered
domestic partnership or civil union?
■ No
■ Yes
PARENT 1 LIVING IN HOUSEHOLD
Answer questions 84 to 105 about yourself if you
are the child’s parent or guardian.
If you are not the child’s parent or guardian, answer
questions 84 to 105 about one of this child’s
parents or guardians living in the household.
89. What was the first language this parent or
guardian learned to speak?
Mark
GO TO question 92
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
84. Is this parent or guardian the child’s…
■ Biological parent
■ Adoptive parent
■ Stepparent
■ Foster parent
■ Grandparent
■ Other guardian
90. What language does this person speak most
at home now?
Mark
85. Is this person male or female?
86. What is this person’s current marital status?
ONE only.
■ Now married
■ Widowed
■ Divorced
■ Separated
■ Never Married
GO TO question 89
91. How difficult is it for this person to participate
in activities at this child's school because
he/she speaks a language other than
English?
■ Very difficult
■ Somewhat difficult
■ Not at all difficult
87. Is this person currently living with a
boyfriend/girlfriend or partner in this
household?
■ No
■ Yes
ONE only.
GO TO question 92
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
■ Male
■ Female
Mark
ONE only.
► Continue with question 92 on the next page.
GO TO question 89
20
Version A
96. What is the highest grade or level of school
that this parent or guardian completed?
92. Where was this parent or guardian born?
■ One of the 50 United States or the District
Mark
ONE only.
■ 8 grade or less
■ High school, but no diploma
■ High school diploma or equivalent (GED)
■ Vocational diploma after high school
■ Some college, but no degree
■ Associate’s degree (AA, AS)
■ Bachelor’s degree (BA, BS)
■ Some graduate or professional education,
of Columbia
th
GO TO question 94
■ One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
■ Another country
93. How old was this person when he or she
first moved to the 50 United States or the
District of Columbia?
age
but no degree
■ Master’s degree (MA, MS)
■ Doctorate degree (PhD, EdD)
■ Professional degree beyond bachelor’s
94. Is this person of Spanish, Hispanic, or Latino
origin?
■ No
■ Yes
degree (MD, DDS, JD, LLB)
97. Is he or she currently attending or enrolled
in a school, college, university, or adult
learning center, or receiving vocational
education or job training?
95. What is this person’s race? You may mark
one or more races.
■ American Indian or Alaska Native
■ Asian
■ Black or African American
■ Native Hawaiian or other Pacific Islander
■ White
■ No
■ Yes
98. Which of the following best describes this
person’s employment status?
Mark
ONE only.
■ Employed for pay or income
■ Self-employed
■ Unemployed or
out of work
■ Full-time student
■ Stay at home
GO TO question 101
parent
■ Retired
■ Disabled or
unable to work
21
GO TO question 102
Version A
99. (If employed or self-employed) Does he or
she mostly work a regular day shift, regular
shift other than during the day, variable
shifts or works when work is available?
Mark
105. How old was this person when he or she
first became a parent to any child?
ONE only.
age
■ Don’t know
■ Regular day shift most of the hours
between 6 am to 6 pm
■ A regular shift at times other than between
► Continue with question 106 on the next
page.
6 am and 6 pm
■ A variable shift-one that changes from days
to evenings or nights
■ Where he/she chooses their own hours
■ Works when work is available
100. About how many hours per week does he or
she usually work for pay or income,
counting all jobs?
GO TO question 102
hours
101. (If unemployed or out of work) Has this
parent or guardian been actively looking for
work in the past 4 weeks?
■ No
■ Yes
102. In the past 12 months, how many months (if
any) has this person worked for pay or
income?
Months
103. Have this child’s after-school care needs
influenced this person’s choice of job or
work schedule in any way?
■ No
■ Yes
104. How old is this person?
age
22
Version A
PARENT 2 LIVING IN HOUSEHOLD
111. Is this person currently in a registered
domestic partnership or civil union?
Answer questions 106 to 128 about a second
parent or guardian living in the household.
■ No
■ Yes
106. Is there a second parent or guardian living
in this household?
■ No
■ Yes
GO TO question 129
112. What was the first language this parent or
guardian learned to speak?
Mark
107. Is this person the child’s…
GO TO question 115
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
■ Biological parent
■ Adoptive parent
■ Stepparent
■ Foster parent
■ Grandparent
■ Other guardian
113. What language does this person speak
most at home now?
108. Is this person male or female?
Mark
■ Male
■ Female
ONE only.
■ Now married
■ Widowed
■ Divorced
■ Separated
■ Never Married
GO TO question 112
114. How difficult is it for this person to
participate in activities at this child's school
because he/she speaks a language other
than English?
■Very difficult
■Somewhat difficult
■Not at all difficult
110. Is this person currently living with a
boyfriend/girlfriend or partner in this
household?
■ No
■ Yes
ONE only.
■ English
GO TO question 115
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
109. What is their current marital status?
Mark
ONE only.
GO TO question 112
► Continue with question 115 on the next
page.
23
Version A
115. Where was this parent or guardian born?
119.
■ One of the 50 United States or the District
of Columbia
What is the highest grade or level of
school that this parent or guardian
completed?
Mark [X] ONE only.
GO TO question 117
■ 8 grade or less
■ High school, but no diploma
■ High school diploma or equivalent (GED)
■ Vocational diploma after high school
■ Some college, but no degree
■ Associate’s degree (AA, AS)
■ Bachelor’s degree (BA, BS)
■ Some graduate or professional education,
■ One of the U.S. territories
th
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
■ Another country
116. How old was this person when he or she
first moved to the 50 United States or the
District of Columbia?
age
117. Is this person of Spanish, Hispanic, or Latino
origin?
but no degree
■ Master’s degree (MA, MS)
■ Doctorate degree (PhD, EdD)
■ Professional degree beyond bachelor’s
■ No
■ Yes
degree (MD, DDS, JD, LLB)
118. What is this person’s race? You may mark
one or more races.
■ American Indian or Alaska Native
■ Asian
■ Black or African American
■ Native Hawaiian or other Pacific Islander
■ White
120. Is he or she currently attending or enrolled
in a school, college, university, or adult
learning center, or receiving vocational
education or job training?
■ No
■ Yes
121. Which of the following best describes this
person’s employment status?
Mark
ONE only.
■ Employed for pay or income
■ Self-employed
■ Unemployed or
out of work
■ Full-time student
■ Stay at home
parent
■ Retired
■ Disabled or
unable to work
24
GO TO question 124
GO TO question 125
Version A
122. (If employed or self-employed) Does he or
she mostly work a regular day shift, regular
shift other than during the day, variable shifts or
works when work is available?
Mark
127. How old is this person?
age
ONE only.
■ Regular day shift most of the hours
128. How old was this person when he or she
first became a parent to any child?
between 6 am to 6 pm
■ A regular shift at times other than between
6 am and 6 pm
age
■ A variable shift-one that changes from days
■ Don’t know
to evenings or nights
■ Where he/she chooses their own hours
■ Works when work is available
► Continue with section 9, question 129 on the
next page.
123. About how many hours per week does he or
she usually work for pay or income,
counting all jobs?
hours
GO TO question 125
124. (If unemployed or out of work) Has this
parent or guardian been actively looking for
work in the past 4 weeks?
■ No
■ Yes
125. In the past 12 months, how many months
(if any) has this person worked for pay or
income?
Months
126. Have this child’s after-school care needs
influenced this person’s choice of job or work
schedule in any way?
■ No
■ Yes
25
Version A
9. Your Household
131. How are you related to this child?
Mark
Example: Brother(s)
2
Write ‘0’ if none.
This child’s….
ONE only.
■ Mother (birth, adoptive, step, or foster)
■ Father (birth, adoptive, step, or foster)
■ Aunt
■ Uncle
■ Grandmother
■ Grandfather
■ Parent’s girlfriend/ boyfriend/ partner
■ Other relationship – Specify:
129. How many of the following people live in
this household with this child?
Do not include this child in your answer
Number
a. Parent(s)………
b. Brother(s)………
c. Sister(s)………
132. Which language(s) are spoken at home by
the adults in this household?
d. Aunt(s)…………
e. Uncle(s)………
Mark
■ English
■ Spanish or Spanish Creole
■ French (including Patois, Creole, Cajun)
■ Chinese
■ Other languages – Specify:
f. Grandmother(s)
g. Grandfather(s)…
h. Cousin(s)………
i.
Parent’s
girlfriend/
boyfriend/ partner
j.
Other relative(s)...
all that apply.
k. Other non-
► Continue with question 133 on the next
page.
relative(s)………
130. Enter the total number of people living in
this household with this child. (This number
should be equal to the sum of a through k
above).
Do not include this child in your answer
26
Version A
135. How many years have you lived at this
address?
133. In the past 12 months, did your family ever
receive benefits from any of the following
programs?
Mark
Write ‘0’ if less than 1 year.
ONE box for each item below.
No
▼
years at this address
Yes
136. Is this house…
▼
Mark
a. Temporary Assistance for
Needy Families, or TANF ............
ONE only.
■ Owned or being bought by someone in this
household,
b. Your state welfare or family
assistance program......................
■ Rented by someone in this household, or
■ Occupied by some other arrangement?
c. Women, Infants, and Children,
or WIC ..........................................
d. Food Stamps or Supplemental
Nutrition Assistance Program
(SNAP) .........................................
137. Other than this address, does anyone in this
household currently receive mail at another
address including P.O. Boxes?
■ No
■ Yes
e. Medicaid .......................................
f. Child Health Insurance Program
(CHIP) ..........................................
138. Do you have access to the internet at this
address?
g. Section 8 housing assistance ......
■ No
■ Yes
134. Which category best fits the total income of
all persons in your household over the past 12
months?
Include your own income.
139. Is there at least one telephone inside this
home that is currently working and not a cell
phone?
Include money from jobs or other earnings,
pensions, interest, rent, Social Security payments,
and so on.
■ No
■ Yes
■ $0 to $10,000
■ $10,001 to $20,000
■ $20,001 to $30,000
■ $30,001 to $40,000
■ $40,001 to $50,000
■ $50,001 to $60,000
■ $60,001 to $75,000
■ $75,001 to $100,000
■ $100,001 to $150,000
■ $150,001 or more
140. Do you have a working cell phone?
■ No
■ Yes
► Continue with question 141 on the next
page.
27
Version A
141.
We would like to identify this child’s school so we can include information about the school
in our study.
Using the list of schools below, mark
the box next to the school this child attends. If this
child’s school is not in this list, GO TO question 142.
School Name
▼
Address
▼
City
▼
{SCHOOL 1 UP TO ~40
CHARACTERS}
{ADDRESS 1 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 2 UP TO ~40
CHARACTERS}
{ADDRESS 2 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 3 UP TO ~40
CHARACTERS}
{ADDRESS 3 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 4 UP TO ~40
CHARACTERS}
{ADDRESS 4 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 5 UP TO ~40
CHARACTERS}
{ADDRESS 5 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 6 UP TO ~40
CHARACTERS}
{ADDRESS 6 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 7 UP TO ~40
CHARACTERS}
{ADDRESS 7 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 8 UP TO ~40
CHARACTERS}
{ADDRESS 8 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 9 UP TO ~40
CHARACTERS}
{ADDRESS 9 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 10 UP TO ~40
CHARACTERS}
{ADDRESS 10 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 11 UP TO ~40
CHARACTERS}
{ADDRESS 11 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 12 UP TO ~40
CHARACTERS}
{ADDRESS 12 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 13 UP TO ~40
CHARACTERS}
{ADDRESS 13 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 14 UP TO ~40
CHARACTERS}
{ADDRESS 14 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 15 UP TO ~40
CHARACTERS}
{ADDRESS 15 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
28
Version A
If you found and marked this child’s school in the list provided in question 141, then
SKIP this question and return your survey in the postage-paid envelope. Otherwise,
continue with question 142.
142. To help us identify the school this child attends, write the name and address of
this child’s school in the spaces below.
Please use block or capital letters, for example:
a. School name
SCHOOL NAME
b. School street address
NUMBER AND STREET ADDRESS
c. School city
CITY
d. School state
STATE
e. School zip code
ZIP
Thank you.
Please return this questionnaire in the
postage-paid envelope provided. If you have
lost the envelope, mail the completed
questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
29
S C
H
O
O
L
Version A
THIS PAGE INTENTIONALLY LEFT BLANK
30
Version A
THIS PAGE INTENTIONALLY LEFT BLANK
31
Version A
Commonly Asked Questions
Q: How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation. It was
selected using scientific sampling methods to represent other households in the United States.
Q: How did you get my child’s name and grade?
A: When you returned the initial National Household Education Survey to us, we randomly chose one
child to ask additional questions about. We are interested in understanding your child’s experiences
with after-school activities.
Q: Why should I take part in this study? Do I have to do this?
A: You represent thousands of other households like yours, and you cannot be replaced. Your
answers and opinions are very important to the success of this study. You may choose not to
answer any or all questions in this survey. In order for the survey to be representative, it is
important that you complete and return this questionnaire. Those who do not return the survey will
not be represented in key statistics used by policymakers and researchers.
Q: How will the information I provide be used? Will my privacy be protected?
A: Your responses will be combined with those of others to produce statistical summaries and reports.
Your individual data will not be reported. Your answers may be used only for statistical purposes
and may not be disclosed, or used, in identifiable form for any other purpose except as required by
law (Section 9573, 20 U.S. Code).
Q: I have more than one child in my household. Will I receive additional surveys for the other
children in my household?
A:
No, each household will receive a survey for only one child, even if there are multiple children living
in the household. In households with multiple children, one child was randomly selected to be
included in the study.
Q: How will my response help the Department of Education?
A: The Department of Education wants to understand the condition of education in the United States.
This survey is the only way that the Department of Education can learn about schooling from your
perspective. Your responses will be combined with those from other households to inform
educators, policymakers, schools, and universities about changes in the condition of education in
the United States. Reports from past surveys can be found at www.nces.ed.gov/nhes.
Q: Who is sponsoring the study? Is this study conducted by the Federal Government?
A: The National Center for Education Statistics (NCES), within the U.S. Department of Education, is
authorized to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this
survey on behalf of NCES. This study has been approved by the Office of Management and Budget
(OMB), the office that reviews all federally sponsored surveys. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB approval number assigned to this study is 18500803. You may send any comments about this survey, including its length, to the Federal
Government. Write to: Sarah Carroll, National Center for Education Statistics, U.S. Department of
Education, 1990 K Street NW, Washington, DC 20006-5650.
32
C.6 ASPA version B
Version B
OMB No. 1850-0803: Approval Expires 9/30/2016
The National Household Education Survey
A Survey about Students’ After-School Activities
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
Version B
Instructions
In response to the survey you answered earlier, we recorded that the
child/youth listed below attends school. If this child is homeschooled
instead of attending public or private school, or if this child has not yet
started kindergarten, please call us at the toll-free number below so we can
be sure you received the correct survey.
These questions should be filled in by a parent or guardian who knows
about:
Please answer all the survey questions thinking about this child or youth.
the box that best represents your
To answer a question, simply mark
answer.
Please use a black or blue pen, if available, to complete this survey.
If this questionnaire has been sent to the wrong household or the
child/youth listed above does not live here, please call to let us know.
Our toll-free number is 1-888-XXX-XXXX.
We are authorized to collect this information by Section 9543, 20 U.S. Code. You do not have to provide
the information requested. However, the information you provide will help the Department of Education’s
ongoing efforts to learn more about the educational experiences of children and families. There are no
penalties should you choose not to participate in this study. Your answers may be used only for statistical
purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required
by law (Section 9573, 20 U.S. Code). Your responses will be combined with those from other participants
to produce summary statistics and reports.
This survey is estimated to take an average of 20 minutes, including time for reviewing instructions, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: Sarah Carroll, National Center for
Education Statistics, U.S. Department of Education, 1990 K Street NW, Washington, DC 20006-5650. Do
not return the completed form to this address.
Version B
5. Is this school a charter school?
1. Child’s Schooling
■ No
■ Yes
► Thank you for your help with the
previous survey your household
completed.
► Answer all the survey questions
thinking about the child listed below:
6. How much do you agree or disagree with
the following statement:
“This child enjoys school.”
■ Strongly agree
■ Agree
■ Disagree
■ Strongly disagree
1. What is this child’s current grade or year of
school?
If this child is not assigned a specific grade,
mark or write the grade he/she would be in at
a school with regular grades.
■ Child has not yet started kindergarten
7. Please tell us about this child’s grades
during this school year. Overall, across all
subjects, what grades does this child get?
Please STOP now and call
1-888-XXX-XXXX.
■ Mostly A’s
■ Mostly B’s
■ Mostly C’s
■ Mostly D’s and lower
■ This child’s school does not give these
■ Full-day kindergarten
■ Partial-day kindergarten
grade (1 through 12)
2. Is this child homeschooled instead of
going to a public or private school for
some classes or subjects?
■ No
■ Yes –
grades
8. Since the beginning of this school year, how
many times have any of this child’s teachers
or school staff contacted your household
about…
For how many hours
each week does this child attend
a public or private school?
Write ‘0’ if none.
Number
3. What type of school does this child attend?
■ Private, Catholic
■ Private, religious
but not Catholic
a. Behavior problems this child is
having in school ............................
b. Problems this child is having with
school work ....................................
GO TO question 6
■ Private, not religious
■ Public school
c. Very good behavior .....................
d. Very good school work ................
4. Is that his or her regularly assigned school
or a school that you chose?
■ Assigned school
■ School of choice
■ Assigned school is school of choice
3
Version B
9.
12. Has this child ever had the following
experiences?
Since the beginning of this school year,
how many days has this child been
absent from school?
Mark
ONE box for each item below.
days
No Yes
▼
10. Since starting kindergarten, has this child
repeated any grades?
■ No
■ Yes
▼
a. An out-of-school suspension .........
b. An in-school suspension not
counting detentions .......................
GO TO question 12
c. Been expelled from school ............
11. What grade or grades did he/she repeat?
Mark
13. How far do you expect this child to go in
his/her education?
all that apply.
Elementary through Middle school
■ Kindergarten
■ First grade
■ Second grade
■ Third grade
■ Fourth grade
■ Fifth grade
■ Sixth grade
■ Seventh grade
■ Eighth grade
Mark
ONE only.
■ Complete less than a high school diploma
■ Graduate from high school
■ Attend a vocational or technical school
after high school
■ Attend two or more years of college
■ Earn a bachelor’s degree
■ Earn a graduate degree or professional
degree beyond a bachelor's
14. How would you describe his/her work at
school?
High school
■ Ninth grade - freshman
■ Tenth grade - sophomore
■ Eleventh grade - junior
■ Twelfth grade - senior
Mark
ONE only.
■ Excellent
■ Above average
■ Average
■ Below average
■ Failing
4
Version B
2. Choosing After-School
Arrangements
18. How satisfied are you with the actual afterschool care, programs, and activities
available to you in your community?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisified
Children spend their after-school time in many
different ways. Some children are with parents or
relatives after-school, some care for themselves,
and others attend a supervised care program or
participate in clubs, lessons, sports or other
organized activities. After-school hours are the
hours after the child is finished with school before
8pm.
19. Is this child’s parent with him or her each
day when this child finishes school until
8pm?
These next questions ask about what is important
to your family when deciding how this child
spends his or her time after-school.
■ No
■ Yes
15. Do you feel there are good choices for
after-school care, programs, or activities
where you live?
20. Not counting times when an adult is at
home and this child is outside playing, is
this child responsible for him or herself
each day for 30 minutes or more after
school?
■ No
■ Yes
■ Don’t know
■ No
■ Yes
16. Does your child’s school or your local
community provide information about
after-school care, programs, or activities
where you live?
21. This school year, does this child attend a
supervised care program, or participate in
clubs, lessons, sports or other organized
activities during after-school hours?
■ No
■ Yes
■ Don’t know
■ No
■ Yes
17. Have you looked for information about
after-school care, programs, or activities
for your child?
GO TO question 27
Continue with question 22 on the
next page.
■ No
■ Yes
5
Version B
23. Of the reasons you marked in question 22,
which three would you say were the most
important when your family was making
decisions about this child’s after-school hours
until 8pm?
Write the letter from question 22.
22. There are many different reasons why
parents select after-school care, programs,
and activities for their children. Which of the
following reasons did you consider when your
family was making decisions about this child’s
after-school hours until 8pm?
1. |__| letter from question 22
Mark all that apply
2. |__| letter from question 22
a. A convenient location
b. Cost
c.
3. |__| letter from question 22
Adult supervision
d. A safe environment
e. A nurturing
environment
f.
Child is cared for by
someone your family
knows
g. Transportation to and
from the care,
program, or activity
h. All my children can be
at the same place
i.
The hours and
schedule are
convenient
j.
Quality of facilities
k.
The provider is
licensed or accredited
l.
Ability of someone to
speak child or family’s
first language
m. Ability of someone to
care for child’s special
needs
n. Adequate number of
staff
o. No other
care/programs
available
6
Version B
25. Of the reasons you marked in question 24,
which three would you say were the most
important when your family was making
decisions about this child’s after-school hours
until 8pm?
Write the letter from question 24.
24. Other than the reasons on the previous
page, which of the following reasons did you
consider when your family was making
decisions about this child’s after-school hours
until 8pm?
Mark all that apply
1. |__| letter from question 24
a. Child enjoys it
2. |__| letter from question 24
b. Child spends time
with other kids his/her
age
c.
3. |__| letter from question 24
Child spends time
with family
26. Other than the reasons listed above, were there
any other reasons your family considered when
making decisions about where this child spends
after-school hours until 8pm?
d. Cultural diversity of
the children
e. Provides music, art,
and culture
f.
Provides access to
computers
g. Provides math and
science activities
h. Provides academic
support/tutoring
i.
Provides help for this
child to learn English
j.
Provides help for this
child to learn another
language
k.
Provides reading
activities
l.
Provides physical
activities
m. Provides mentors or
role models
n. You or your family like
the staff
o. Religious affiliation of
program
7
Version B
28. Last week, how many days did each
person look after this child during after school
hours until 8pm?
27. Last week, how many days was this child
at each location during after school hours
until 8pm?
Mark
ONE box for each item below. If last week
this child missed his or her regular activities, please
answer about the most recent typical week
Mark
ONE box for each item below. If last week
this child missed his or her regular activities, please
answer about the most recent typical week
Child spends at
least 30 minutes…
0
days
▼
1-2
days
▼
3-4
days
▼
5 or
more
days
▼
Child spends at
least 30 minutes…
a. Mother (birth,
adoptive, step, or
foster)…………………
a. At this child’s home ......
b. At another home,
including relative or
care providers home..
b. Father (birth,
adoptive, step, or
foster)…………………
c. At this child’s school ....
c. Grandmother or
Grandfather ..................
d. At a community
center ...........................
d. Aunt or Uncle ...............
e. At a day-care or afterschool care center
located in its own
building ........................
e. Brother or Sister...........
f. Another relative not
listed ............................
f. At a college or
university......................
g. Child takes care of
him/herself for more
than 30 minutes ...........
g. At a library....................
h. A nanny, babysitter,
or another person not
related to the child .......
h. At a church,
synagogue, temple,
or other place of
worship ........................
i. An adult staff person
at a formal afterschool program or
center………..
i. At a parent or
guardian’s workplace ...
j. At another location
not listed,
specify___________
j. An adult at an
organized club, sports
or activity (e.g.,
coach, art teacher)…
8
0
days
▼
1-2
days
▼
3-4
days
▼
5 or
more
days
▼
Version B
30. Last week, how many days did this child
participate in the following activities
during after school hours until 8pm?
29. Last week, how many days did this child
participate in the following activities during
after school hours until 8pm?
Mark
ONE box for each item below. If last week
this child missed his or her regular activities, please
answer about the most recent typical week
0
days
▼
1-2
days
▼
3-4
days
▼
Mark
ONE box for each item below. If last week
this child missed his or her regular activities, please
answer about the most recent typical week
5 or
more
days
▼
0
days
▼
a.Sports (team or
individual) ......................
a. Homework ..............
b. Receiving tutoring ..
b.Physical activities, like
jumping rope, biking,
dancing .........................
c. Reading or
writing for fun ........
c.Other playing
outdoors ........................
d. Mathematics, like
math labs or math
clubs ......................
d.Playing indoors, like
playing board games
and playing with toys
inside ............................
e. Science, like
science labs or
science club ...........
e.Socializing with
friends ...........................
f. Engineering or
technology like
computer
programming or
robotics .................
f. Watching TV or
movies (includes
things like, online
streaming, Netflix,
VHS, DVD, or Bluray) ................................
g. Music, like
lessons, band, or
chorus ....................
g.Playing video games,
like computer games,
games for Xbox, Wii,
and PlayStation.............
h. Arts, like drawing,
painting,
performing, or
dance lessons ........
h.Using a smart phone,
computer, or tablet,
for Facebook, Twitter,
Instagram, or Internet
browsing (Does not
include computer
games and
homework) ....................
i. School clubs, like
yearbook, chess
or debate
team……………
…
j. Community
activities, like 4-H
and scouts
…………
i. Working at a
job………….
k. Volunteering…….
j. Chores………………
…….
l. A religious
activity……
k.Taking care of a
sibling...
.
.
l. Another activity not
listed,
Specify:___________
9
1-2
days
▼
3-4
days
▼
5 or
more
days
▼
Version B
34. If you answered No to question 31, GO TO question
49, otherwise continue with question 35.
3. Formal After-School
Programs
35. How many different formal after-school
programs does this child attend?
■ One
■ Two
■ Three or more
The Department of Education would like to know
more information about formal after-school
programs that children attend. These are
programs that provide supervision and structured
activities. These programs are usually held in a
school or a center, and are different from
individual activities like sports, scouts, clubs, or
special lessons.
36. How many hours each week does this
child spend at formal after-school
program(s) or center(s) after school,
before 8pm?
31. Is this child now attending an after-school
program at a school or in a center, either
on a scheduled or a drop-in basis, at least
once each week?
■ No
■ Yes
hours each week
37. These next questions ask about the afterschool program where this child spends
the most time.
GO TO question 35
Is there any charge or fee for this program,
paid either by you or some other person or
agency?
32. In the past year, have you tried to enroll
this child in an after-school program either
at your child’s school or at another
location?
■ No
■ Yes
■ No
■ Yes
38. Do any of the following people,
programs, or organizations help pay for
this child to go to this program?
33. What is the main reason you did not enroll
this child in an after-school program in a
school or center?
Mark
ONE box
Mark
ONE box for each item below.
No
▼
Child did not need to be in a program
Child was not eligible because of
a. A friend or relative of this
child outside your household
who provides money
specifically for that program,
not including general child
support ...............................
grades
Child was not eligible because of age
Hours of the program(s) do not fit
family’s needs
Program(s) are too expensive
Program(s) were at capacity/full
Poor program quality
Staff does not speak child’s primary
GO TO question 41
b. Temporary Assistance for
Needy Families, or TANF ...
GO TO
question
49
language
Transportation was unavailable
Program(s) not available where I live
Other reason not to enroll this child
c.
Another social service,
welfare, or child care agency
d. An employer, not including a
tax-free spending account
for child care .......................
e. Someone else ....................
Specify: ______________________
10
Yes
▼
Version B
43. How would you rate the overall quality of
this program?
Best I can imagine
Better than I expected
Good
Not as good as I expected
Not good enough
■
■
■
■
■
39. How much does your household pay for
this child to go to this program, not
counting any money that you may receive
from others to help pay for care?
Write ‘0’ if your household does not pay for
this program.
$
. .00
Is that amount per…
■ Hour
■ Day
■ Week
■ Month
■ Year
■ Every 2 weeks
■ Other
44. How does this child get to the after-school
program?
Does not need transportation
Parent drives
Friend or relative drives
Activity bus
Public transportation
Other
Specify:
■
■
■
■
■
■
45. Is this program run by his or her
school?
Specify:
■ No
■ Yes
40. How many children from your household is
this amount for, including this child?
■ Do not pay for program
■ This child only
■ 2 children
■ 3 children
■ 4 children
■ 5 or more children
46. How many programs does this child
participate in that are run by his or her
school?
■ None
■ One
■ Two
■ Three or more
41. How many years/months has this child
been attending this program?
years
47. How many hours each weekend does this
child spend at formal after-school
program(s) or center(s)?
months
hours each weekend
48. Last summer, did this child participate
in
any
school
or
center-based
programs, at least once each week for
at least 4 weeks?
42. How often do you or another adult in your
family talk to a staff member at this
program?
■ Less than once a month
■ Once or twice a month
■ Once or twice a week
■ Three or more times a week
■ No
■ Yes
■ Don’t know or can’t remember
11
Version B
53. Do any of the following people, programs,
or organizations help pay for this child to go
to these activities?
4. Organized AfterSchool Activities
Mark
ONE box for each item below
No
▼
a. A friend or relative of this
child outside your household
who provides money
specifically for the activities,
not including general child
support .....................................
The following questions ask about organized
clubs or activities that this child might participate
in outside of school hours that are not part of a
formal after-school program. These might include
activities such as organized sports, music lessons,
scouts, or religious education.
49. Is this child participating in any organized
clubs or activities after school at least
once each week?
■ No
■ Yes
b. Temporary Assistance for
Needy Families, or TANF .........
c. Another social service,
welfare, or child care agency ...
GO TO question 62
d. An employer, not including a
tax-free spending account for
child care ..................................
50. How many hours each week did this child
participate in activities or lessons afterschool, before 8pm?
e. Someone else ..........................
54. How much does your household pay for
this child to participate in organized
activities, not counting any money that
you may receive from others to help pay
for the activities?
hours each week
51. Does this child’s participation in these
activities help to cover the hours when you
need adult supervision for him/her?
Write ‘0’ if your household does not pay for
these activities.
■ No
■ Yes
$
52. Is there any charge or fee for these
activities, paid either by you or some other
person or agency?
■ No
■ Yes
Yes
▼
. .00
Is that amount per…
■ Hour
■ Day
■ Week
■ Month
■ Year
■ Every 2 weeks
■ Other
GO TO question 56
12
Specify:
Version B
60. How many hours each weekend does
this child participate in activities or
lessons?
55. How many children from your household is
this amount for, including this child?
Do not pay for activities
This child only
2 children
3 children
4 children
5 or more children
■
■
■
■
■
■
hours each weekend
61. Last summer, did this child participate
in any organized clubs or activities, at
least once each week for at least 4
weeks?
■ No
■ Yes
■ Don’t know or can’t remember
56. How many years/months has this child been
participating in organized activities afterschool?
years
months
57. How does this child get to the activities?
5. Other Arrangements
■ Does not need transportation
■ Parent drives
■ Friend or relative drives
■ Activity bus
■ Public transportation
■ Other
Specify:
62. How many hours each week is this
child looked after by a relative other
than
this
child’s
parent
(e.g.
grandparent, brother, sister, or other
relative) after school until 8pm?
Write 0 if child was not looked after by a
relative.
hours each week
58. How many activities does this child
participate in that are run by his or her
school?
None
One
Two
Three or more
63. How many hours each week is this
child responsible for himself/herself
for 30 minutes or more at a time after
school until 8pm?
■
■
■
■
Write 0 if child is never responsible for
him or herself for more than 30 minutes at
a time.
59. How often do you or another adult in your
family talk to a coach, supervisor, or staff
member at this child’s after-school
activities?
hours each week
64. How many hours each week is this
child looked after by a nanny,
babysitter, or another person not
related to the child, after school until
8pm?
■ Less than once a month
■ Once or twice a month
■ Once or twice a week
■ Three or more times a week
Write 0 if child was not looked after by
someone not related him or her.
hours each week
13
Version B
65. Last week, what time did this child’s
school day end?
:
■ AM
■ PM
66. Last week, what time is this child’s
bedtime during the school week?
:
■ AM
■ PM
.
14
Version B
6. Child’s Health
69. Did you mark
question 69?
67. In general, how would you describe this
child’s health?
■ No
■ Yes
■ Excellent
■ Very good
■ Good
■ Fair
■ Poor
■ No
■ Yes
GO TO question 77
GO TO question 76
71. Are any of these services provided through
an Individualized Education Program (IEP)?
■ No
■ Yes
all that apply.
No
▼
Yes
▼
72. Are any of these services provided during
after-school hours?
a. A specific learning disability ..
■ No
■ Yes
b. An intellectual disability (mental
retardation) ............................
c. A speech or language
impairment ............................
GO TO question 76
73. Who mainly provides services for this
child after-school?
d. A serious emotional disturbance
..............................................
Mark
e. Deafness or another hearing
impairment ............................
ONE box for each item below.
No
▼
f. Blindness or another visual
impairment not corrected with
glasses ..................................
a. Your local school district ..............
g. An orthopedic impairment .....
b. A state or local health or social
service agency .............................
h. Autism ...................................
i. Pervasive Developmental
Disorder (PDD)………………….
c. A community center or
organization ..................................
j. Attention Deficit Disorder, ADD
or ADHD ................................
c. A private doctor, clinic, or other
health care provider .....................
k. A developmental delay..........
l
in
70. Is this child receiving services for his/her
condition?
68. Has a health or education professional told
you that this child has any of the following
conditions?
Mark
yes any condition
Traumatic brain injury………….
m. Another health impairment
lasting 6 months or more ...... ….
15
Yes
▼
Version B
d. The service provider’s commitment to
help your child learn?
74. Where does this child typically receive
services during after-school?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
■ At this child’s home
■ At another private home
■ At this child’s school
■ At an after-school center
■ At a hospital, doctor’s office, or clinic
■ Someplace else
76. Does this child’s condition interfere with
his/her ability to do any of the following
things?
75. During this school year, how satisfied or
dissatisfied have you been with the
services this child receives during afterschool hours?
Mark
ONE box for each item below.
■ Child no longer has condition
a. The service provider’s communication
with your family?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
No
▼
a. Learn................................... .. ….
b. Participate in sports, clubs, or
other organized activities.........
c. Attend school on a regular
basis........................................
d. Make friends............................
b. The child’s service provider?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
► Continue with question 77 on the next
page.
c. The service provider’s ability to
accommodate the child’s special needs?
■ Very satisfied
■ Somewhat satisfied
■ Somewhat dissatisfied
■ Very dissatisfied
■ Does not apply
16
Yes
▼
Version B
83. Does this child split his or her time between
two households, for example, because of a joint
custody arrangement?
7. Child’s Background
77. In what month and year was this child born?
Do not include vacation properties.
■ No
■ Yes
/
month
year
78. Where was this child born?
■ One of the 50 United States or the District
84. What language does this child speak most
at home?
of Columbia
Mark
GO TO question 80
ONE only.
■ Child is not able
■ One of the U.S. territories
to speak
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
GO TO question 86
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
■ Another country
79. How old was this child when he/she first
moved to the 50 United States or the
District of Columbia?
age
85. Is this child currently enrolled in English
as a second language, bilingual education,
or an English immersion program?
80. Is this child of Spanish, Hispanic, or Latino
origin?
■ No
■ Yes
■ No
■ Yes
► Continue with section 8, on the next page.
81. What is this child’s race? You may mark
one or more races.
■ American Indian or Alaska Native
■ Asian
■ Black or African American
■ Native Hawaiian or other Pacific Islander
■ White
82. What is this child’s sex?
■ Male
■ Female
17
Version B
8. Child’s Family
89. What was the first language this parent or
guardian learned to speak?
PARENT 1 LIVING IN HOUSEHOLD
Mark
Answer questions 86 to 105 about yourself if you
are the child’s parent or guardian.
GO TO question 92
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
If you are not the child’s parent or guardian, answer
questions 86 to 105 about one of this child’s
parents or guardians living in the household.
86. Is this parent or guardian the child’s…
■ Biological parent
■ Adoptive parent
■ Stepparent
■ Foster parent
■ Grandparent
■ Other guardian
90. What language does this person speak most
at home now?
Mark
ONE only.
GO TO question 92
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
87. Is this person male or female?
■ Male
■ Female
91. How difficult is it for this person to participate
in activities at this child's school because
he/she speaks a language other than
English?
88. What is the current marital or partner status
of this parent or guardian?
Mark
ONE only.
■ Very difficult
■ Somewhat difficult
■ Not at all difficult
ONE only.
■ Married
■ In a registered domestic partnership or civil
union
■ Living with a partner
■ Seperated
■ Divorced
■ Widowed
■ Never Married
► Continue with question 92 on the next page.
18
Version B
96. What is the highest grade or level of school
that this parent or guardian completed?
92. Where was this parent or guardian born?
■ One of the 50 United States or the District
Mark
ONE only.
■ 8 grade or less
■ High school, but no diploma
■ High school diploma or equivalent (GED)
■ Vocational diploma after high school
■ Some college, but no degree
■ Associate’s degree (AA, AS)
■ Bachelor’s degree (BA, BS)
■ Some graduate or professional education,
of Columbia
th
GO TO question 94
■ One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
■ Another country
93. How old was this person when he or she
first moved to the 50 United States or the
District of Columbia?
age
but no degree
■ Master’s degree (MA, MS)
■ Doctorate degree (PhD, EdD)
■ Professional degree beyond bachelor’s
94. Is this person of Spanish, Hispanic, or Latino
origin?
■ No
■ Yes
degree (MD, DDS, JD, LLB)
97. Is he or she currently attending or enrolled
in a school, college, university, or adult
learning center, or receiving vocational
education or job training?
95. What is this person’s race? You may mark
one or more races.
■ American Indian or Alaska Native
■ Asian
■ Black or African American
■ Native Hawaiian or other Pacific Islander
■ White
■ No
■ Yes
98. Which of the following best describes this
person’s employment status?
Mark
ONE only.
■ Employed for pay or income
■ Self-employed
■ Unemployed or
out of work
■ Full-time student
■ Stay at home
GO TO question 101
parent
■ Retired
■ Disabled or
unable to work
19
GO TO question 102
Version B
99. (If employed or self-employed) Does he or
she mostly work a regular day shift, regular
shift other than during the day, variable
shifts or works when work is available?
Mark
105. How old was this person when he or she
first became a parent to any child?
ONE only.
age
■ Don’t know
■ Regular day shift most of the hours
between 6 am to 6 pm
■ A regular shift at times other than between
► Continue with question 106 on the next
page.
6 am and 6 pm
■ A variable shift-one that changes from days
to evenings or nights
■ Where he/she chooses their own hours
■ Works when work is available
100. About how many hours per week does he or
she usually work for pay or income,
counting all jobs?
GO TO question 102
hours
101. (If unemployed or out of work) Has this
parent or guardian been actively looking for
work in the past 4 weeks?
■ No
■ Yes
102. In the past 12 months, how many months (if
any) has this person worked for pay or
income?
Months
103. Have this child’s after-school care needs
influenced this person’s choice of job or
work schedule in any way?
■ No
■ Yes
104. How old is this person?
age
20
Version B
PARENT 2 LIVING IN HOUSEHOLD
Answer questions 106 to 126 about a second
parent or guardian living in the household.
110. What was the first language this parent or
guardian learned to speak?
106. Is there a second parent or guardian living
in this household?
■ No
■ Yes
Mark
GO TO question 113
■ English
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
GO TO question 127
107. Is this person the child’s…
■ Biological parent
■ Adoptive parent
■ Stepparent
■ Foster parent
■ Grandparent
■ Other guardian
111. What language does this person speak
most at home now?
Mark
ONE only.
■ English
GO TO question 113
■ Spanish
■ A language other than English or Spanish
■ English and Spanish equally
■ English and another language equally
108. Is this person male or female?
■ Male
■ Female
109. What is the current marital or partner
status of this parent or guardian?
Mark
ONE only.
112. How difficult is it for this person to
participate in activities at this child's school
because he/she speaks a language other
than English?
ONE only.
■ Married
■ In a registered domestic partnership or civil
■Very difficult
■Somewhat difficult
■Not at all difficult
union
■ Living with a partner
■ Seperated
■ Divorced
■ Widowed
■ Never Married
► Continue with question 113 on the next
page.
21
Version B
113. Where was this parent or guardian born?
117.
■ One of the 50 United States or the District
of Columbia
What is the highest grade or level of
school that this parent or guardian
completed?
Mark [X] ONE only.
GO TO question 115
■ 8 grade or less
■ High school, but no diploma
■ High school diploma or equivalent (GED)
■ Vocational diploma after high school
■ Some college, but no degree
■ Associate’s degree (AA, AS)
■ Bachelor’s degree (BA, BS)
■ Some graduate or professional education,
■ One of the U.S. territories
th
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
■ Another country
114. How old was this person when he or she
first moved to the 50 United States or the
District of Columbia?
age
115. Is this person of Spanish, Hispanic, or Latino
origin?
but no degree
■ Master’s degree (MA, MS)
■ Doctorate degree (PhD, EdD)
■ Professional degree beyond bachelor’s
■ No
■ Yes
degree (MD, DDS, JD, LLB)
116. What is this person’s race? You may mark
one or more races.
■ American Indian or Alaska Native
■ Asian
■ Black or African American
■ Native Hawaiian or other Pacific Islander
■ White
118. Is he or she currently attending or enrolled
in a school, college, university, or adult
learning center, or receiving vocational
education or job training?
■ No
■ Yes
119. Which of the following best describes this
person’s employment status?
Mark
ONE only.
■ Employed for pay or income
■ Self-employed
■ Unemployed or
out of work
■ Full-time student
■ Stay at home
parent
■ Retired
■ Disabled or
unable to work
22
GO TO question 122
GO TO question 123
Version B
120. (If employed or self-employed) Does he or
she mostly work a regular day shift, regular
shift other than during the day, variable shifts or
works when work is available?
Mark
125. How old is this person?
age
ONE only.
■ Regular day shift most of the hours
126. How old was this person when he or she
first became a parent to any child?
between 6 am to 6 pm
■ A regular shift at times other than between
6 am and 6 pm
age
■ A variable shift-one that changes from days
■ Don’t know
to evenings or nights
■ Where he/she chooses their own hours
■ Works when work is available
► Continue with section 9, question 127 on the
next page.
121. About how many hours per week does he or
she usually work for pay or income,
counting all jobs?
hours
GO TO question 123
122. (If unemployed or out of work) Has this
parent or guardian been actively looking for
work in the past 4 weeks?
■ No
■ Yes
123. In the past 12 months, how many months
(if any) has this person worked for pay or
income?
Months
124. Have this child’s after-school care needs
influenced this person’s choice of job or work
schedule in any way?
■ No
■ Yes
23
Version B
9. Your Household
129. How are you related to this child?
127. How many of the following people live in
this household with this child?
Do not include this child in your answer
Example: Brother(s)
Mark
■ Mother (birth, adoptive, step, or foster)
■ Father (birth, adoptive, step, or foster)
■ Aunt
■ Uncle
■ Grandmother
■ Grandfather
■ Parent’s girlfriend/ boyfriend/ partner
■ Other relationship – Specify:
2
Write ‘0’ if none.
This child’s….
ONE only.
Number
a. Parent(s)………
b. Brother(s)………
c. Sister(s)………
d. Aunt(s)…………
130. Which language(s) are spoken at home by
the adults in this household?
e. Uncle(s)………
Mark
f. Grandmother(s)
■ English
■ Spanish or Spanish Creole
■ French (including Patois, Creole, Cajun)
■ Chinese
■ Other languages – Specify:
g. Grandfather(s)…
h. Cousin(s)………
i.
Parent’s
girlfriend/
boyfriend/ partner
j.
Other relative(s)...
all that apply.
k. Other nonrelative(s)………
► Continue with question 131 on the next
page.
128. Enter the total number of people living in
this household with this child. (This number
should be equal to the sum of a through k
above).
Do not include this child in your answer
24
Version B
133. How many years have you lived at this
address?
131. In the past 12 months, did your family ever
receive benefits from any of the following
programs?
Mark
Write ‘0’ if less than 1 year.
ONE box for each item below.
No
▼
years at this address
Yes
134. Is this house…
▼
Mark
a. Temporary Assistance for
Needy Families, or TANF ............
ONE only.
■ Owned or being bought by someone in this
household,
b. Your state welfare or family
assistance program......................
■ Rented by someone in this household, or
■ Occupied by some other arrangement?
c. Women, Infants, and Children,
or WIC ..........................................
d. Food Stamps or Supplemental
Nutrition Assistance Program
(SNAP) .........................................
135. Other than this address, does anyone in this
household currently receive mail at another
address including P.O. Boxes?
■ No
■ Yes
e. Medicaid .......................................
f. Child Health Insurance Program
(CHIP) ..........................................
136. Do you have access to the internet at this
address?
g. Section 8 housing assistance ......
■ No
■ Yes
132. Which category best fits the total income of
all persons in your household over the past 12
months?
Include your own income.
137. Is there at least one telephone inside this
home that is currently working and not a cell
phone?
Include money from jobs or other earnings,
pensions, interest, rent, Social Security payments,
and so on.
■ No
■ Yes
■ $0 to $10,000
■ $10,001 to $20,000
■ $20,001 to $30,000
■ $30,001 to $40,000
■ $40,001 to $50,000
■ $50,001 to $60,000
■ $60,001 to $75,000
■ $75,001 to $100,000
■ $100,001 to $150,000
■ $150,001 or more
138. Do you have a working cell phone?
■ No
■ Yes
► Continue with question 139 on the next
page.
25
Version B
139.
We would like to identify this child’s school so we can include information about the school
in our study.
Using the list of schools below, mark
the box next to the school this child attends. If this
child’s school is not in this list, GO TO question 140.
School Name
▼
Address
▼
City
▼
{SCHOOL 1 UP TO ~40
CHARACTERS}
{ADDRESS 1 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 2 UP TO ~40
CHARACTERS}
{ADDRESS 2 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 3 UP TO ~40
CHARACTERS}
{ADDRESS 3 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 4 UP TO ~40
CHARACTERS}
{ADDRESS 4 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 5 UP TO ~40
CHARACTERS}
{ADDRESS 5 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 6 UP TO ~40
CHARACTERS}
{ADDRESS 6 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 7 UP TO ~40
CHARACTERS}
{ADDRESS 7 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 8 UP TO ~40
CHARACTERS}
{ADDRESS 8 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 9 UP TO ~40
CHARACTERS}
{ADDRESS 9 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 10 UP TO ~40
CHARACTERS}
{ADDRESS 10 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 11 UP TO ~40
CHARACTERS}
{ADDRESS 11 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 12 UP TO ~40
CHARACTERS}
{ADDRESS 12 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 13 UP TO ~40
CHARACTERS}
{ADDRESS 13 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 14 UP TO ~40
CHARACTERS}
{ADDRESS 14 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
{SCHOOL 15 UP TO ~40
CHARACTERS}
{ADDRESS 15 UP TO ~30
CHARACTERS}
{CITY UP TO ~15
CH.}
26
Version B
If you found and marked this child’s school in the list provided in question 139, then
SKIP this question and return your survey in the postage-paid envelope. Otherwise,
continue with question 140.
140. To help us identify the school this child attends, write the name and address of
this child’s school in the spaces below.
Please use block or capital letters, for example:
a. School name
SCHOOL NAME
b. School street address
NUMBER AND STREET ADDRESS
c. School city
CITY
d. School state
STATE
e. School zip code
ZIP
Thank you.
Please return this questionnaire in the
postage-paid envelope provided. If you have
lost the envelope, mail the completed
questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
27
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O
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Version B
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28
Version B
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29
Version B
Commonly Asked Questions
Q: How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation. It was
selected using scientific sampling methods to represent other households in the United States.
Q: How did you get my child’s name and grade?
A: When you returned the initial National Household Education Survey to us, we randomly chose one
child to ask additional questions about. We are interested in understanding your child’s experiences
with after-school activities.
Q: Why should I take part in this study? Do I have to do this?
A: You represent thousands of other households like yours, and you cannot be replaced. Your
answers and opinions are very important to the success of this study. You may choose not to
answer any or all questions in this survey. In order for the survey to be representative, it is
important that you complete and return this questionnaire. Those who do not return the survey will
not be represented in key statistics used by policymakers and researchers.
Q: How will the information I provide be used? Will my privacy be protected?
A: Your responses will be combined with those of others to produce statistical summaries and reports.
Your individual data will not be reported. Your answers may be used only for statistical purposes
and may not be disclosed, or used, in identifiable form for any other purpose except as required by
law (Section 9573, 20 U.S. Code).
Q: I have more than one child in my household. Will I receive additional surveys for the other
children in my household?
A:
No, each household will receive a survey for only one child, even if there are multiple children living
in the household. In households with multiple children, one child was randomly selected to be
included in the study.
Q: How will my response help the Department of Education?
A: The Department of Education wants to understand the condition of education in the United States.
This survey is the only way that the Department of Education can learn about schooling from your
perspective. Your responses will be combined with those from other households to inform
educators, policymakers, schools, and universities about changes in the condition of education in
the United States. Reports from past surveys can be found at www.nces.ed.gov/nhes.
Q: Who is sponsoring the study? Is this study conducted by the Federal Government?
A: The National Center for Education Statistics (NCES), within the U.S. Department of Education, is
authorized to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this
survey on behalf of NCES. This study has been approved by the Office of Management and Budget
(OMB), the office that reviews all federally sponsored surveys. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB approval number assigned to this study is 18500803. You may send any comments about this survey, including its length, to the Federal
Government. Write to: Sarah Carroll, National Center for Education Statistics, U.S. Department of
Education, 1990 K Street NW, Washington, DC 20006-565
30
| File Type | application/pdf |
| Author | Sarah Hastedt |
| File Modified | 2013-10-17 |
| File Created | 2013-10-17 |