OMB #:
Expiration
Date:
Evaluation of the DC Opportunity Scholarship Program
High School (Grades 9-12)
Student Questionnaire
Spring 2013
According to the Paperwork
Reduction Act of 1995, no persons are required to respond to a
collection of information unless such collection displays a valid
OMB control number. The valid OMB control number for this
information collection is xxxx-xxxx. Public reporting burden
for this collection is estimated to average 15
minutes per
response, including the time to review instructions, search existing
data resources, gather the data needed, and complete and review the
information collection. The obligation to respond to this
collection is required to obtain or retain benefits. “The
authorizing statute includes an expectation that the mandated
evaluation, in collaboration with the program operator, “ensure
that the parents of each student who applies for a scholarship under
this division… and the parents of each student participating
in the scholarship program under this division, agree that the
student will participate in the measurements given annually by the
Institute of Education Sciences…” SOAR Act Sec.
3009(a)(3)(C). The program operator has determined that to
meet this requirement, participants are obligated to participate in
the measurements (data collection) or they could lose their
scholarship award.”
Send comments regarding the
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to the
U.S. Department of Education, 400 Maryland Avenue, S.W., LBJ, Room
2E117, Washington, DC 20210-4537 or send electronically through the
Federal eRulemaking Portal at http://www.regulations.gov
by selecting the Docket ID number.
Please answer all the questions.
Part 1: About You
This first section asks questions about you.
Q1. What is your gender
( Check one)
Male or 1
Female? 2
Q2. How often do you read books that are not assigned by your teacher?
( Check one)
Every day 1
Most days 2
Some days 3
Never 4
Q3. How far do you expect to go in school?
( Check one)
Less than high school completion 1
Complete a high school diploma, GED or alternative high school credential 2
Complete a certificate or diploma from a school that provides occupational training 3
Complete an Associate’s degree 4
Complete a Bachelor’s degree 5
Complete a Master’s degree 6
Complete a Ph.D., M.D., law degree, or other high level professional degree 7
Q4. How far in school do you want to go?
( Check one)
Less than high school completion 1
Complete a high school diploma, GED or alternative high school credential 2
Complete a certificate or diploma from a school that provides occupational training 3
Complete an Associate’s degree 4
Complete a Bachelor’s degree 5
Complete a Master’s degree 6
Complete a Ph.D., M.D., law degree, or other high level professional degree 7
Q5. During this year, have you done any of the following?
( Check yes or no on each row)
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Yes |
No |
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2 |
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Q6. On a regular school day, how long are you at home after school with no adult there?
( Check one)
None 0
Less than 1 hour 1
1-2 hours 2
2-3 hours 3
More than 3 hours 4
Q7. Do any of the following encourage you to work harder in school?
( Check one box on each row)
|
A Lot |
A Fair Amount |
A Little Bit |
Not At All |
a.Pressure from my parents |
1 |
2 |
3 |
4 |
b.Pleasing my parents by getting good grades |
1 |
2 |
3 |
4 |
c.Teacher expectations |
1 |
2 |
3 |
4 |
d.Pleasing my teacher |
1 |
2 |
3 |
4 |
e.Encouragement from my teachers |
1 |
2 |
3 |
4 |
f.Learning the material |
1 |
2 |
3 |
4 |
g.Interest in the subject |
1 |
2 |
3 |
4 |
h.Keeping up with my friends |
1 |
2 |
3 |
4 |
i.Getting a better job |
1 |
2 |
3 |
4 |
j.Getting into college |
1 |
2 |
3 |
4 |
k.Pressure from my friends |
1 |
2 |
3 |
4 |
l.Not embarrassing my family |
1 |
2 |
3 |
4 |
Q8. Who has had the most influence on your thinking about careers, if anyone?
( Check one)
A high school counselor 01
A teacher 02
Your parents 03
Another family member 04
Your friends 05
Your employer 06
A military recruiter 07
A coach or scout 08
Yourself 09
No one in particular 10
Q9. Have you ever done any of the following activities [to prepare for life after high school]?
( Check one box on each row)
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Yes |
No |
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1 |
2 |
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1 |
2 |
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1 |
2 |
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1 |
2 |
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1 |
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* An internship is a work-related learning experience for individuals who wish to develop hands on work experience in a certain occupational field. Apprenticeship programs provide formal training in specific occupations; the apprentice/participant learns a trade through on-the-job training and other related instruction, often under the supervision of a journey-level craft person or trade professional.
Q10. Have you ever taken any of the following tests?
( Check one box on each row)
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Never |
Once |
Twice |
Three |
Don’t
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1 |
2 |
3 |
4 |
5 |
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1 |
2 |
3 |
4 |
5 |
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1 |
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5 |
Q11. Do you agree or disagree with the following statements:
( Check one box on each row)
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Agree strongly |
Agree |
Disagree |
Disagree strongly |
a.Even if you study, you will not be able to get into college |
1 |
2 |
3 |
4 |
b.Even if you study, your family cannot afford to pay for you to attend college |
1 |
2 |
3 |
4 |
c.Working is more important for you than attending college |
1 |
2 |
3 |
4 |
d.Studying in school rarely pays off later with good jobs 1 2 3 4 |
1 |
2 |
3 |
4 |
Part 2: About Your School
This section asks questions about the overall climate at your school, support from teachers and other adults in the school and other students’ attitudes.
Q12. Do you agree or disagree with these statements about your school?
( Check one box on each row)
|
Agree strongly |
Agree |
Disagree |
Disagree strongly |
a.Students are proud to go to this school |
1 |
2 |
3 |
4 |
b.Students at this school have a lot of opportunities to learn |
1 |
2 |
3 |
4 |
c.Rules of behavior are strict |
1 |
2 |
3 |
4 |
d.People at my school are supportive of each other |
1 |
2 |
3 |
4 |
e.I feel lonely at my school |
1 |
2 |
3 |
4 |
f.I enjoy going to school |
1 |
2 |
3 |
4 |
g.There is respect, among students and teachers, for other religions and cultures, at my school |
1 |
2 |
3 |
4 |
h.Students are taught to be kind and responsible for their actions |
1 |
2 |
3 |
4 |
Q13. Overall, how safe do you feel your school is?
Very safe 1
Somewhat safe 2
Not safe 3
Q14. Did the following ever happen to you at school this year?
( Check one box on each row)
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Never |
Once or twice |
3 times or more |
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1 |
2 |
3 |
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1 |
2 |
3 |
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1 |
2 |
3 |
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3 |
Q15. Do you agree or disagree with these statements about the teachers and other adults at your
school?
( Check one box on each row)
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Agree strongly |
Agree |
Disagree |
Disagree strongly |
At my school, there is a teacher or some other adult who… |
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4 |
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Q16. During the current school year (2012-2013), have teachers and other school staff provided you with support? Did it help you stay in school or prepare for life after school?
( Check two boxes on each row)
|
Yes |
No |
Very Helpful |
Somewhat Helpful |
Not Helpful |
Not Applicable (N/A) |
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1 |
2 |
1 |
2 |
3 |
4 |
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Q17. Do you agree or disagree with these statements about the students at your school?
( Check one box on each row)
|
Agree strongly |
Agree |
Disagree |
Disagree strongly |
At my school, students… |
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1 |
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3 |
4 |
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4 |
Q18. What overall grade would you give your school?
( Check one)
A-Excellent 1
B-Good 2
C-Fair 3
D-Unsatisfactory 4
F-Failing 5
Part 3: About Your Math and English Classes
This next section asks questions about the classes you are taking at school.
Q19. During this year, have you taken classes in?
( Check yes or no on each row)
|
Yes |
No |
|
1 |
2 |
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1 |
2 |
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1 |
2 |
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1 |
2 |
Q20. How much do you agree or disagree with the following statements about your English and Math
teachers? Remember, none of your teachers or your principal will see any of the answers you
provide. Your English/Math teacher…
( Check one box on each row)
|
Agree strongly |
Agree |
Disagree |
Disagree strongly |
|
1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
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1 |
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Q21. To what extent do you understand what is being taught in your English or Math class?
English Math
None of the time 1 1
Less than half the time 2 2
About half the time 3 3
More than half the time 4 4
All the time 4 4
Q22.
English Math
H
(your best guess is fine)
Q23. On average, how many hours do you spend doing math or English homework per week?
( Check one)
Math English
Zero to 5 hours 0 0
5 to 10 hours 1 1
More than 10 hours 2 2
Part 4: About Your Friends
This section asks questions about your friends.
Q24. How many of your close friends do your parents know by name?
( Check one)
All of them 1
Most of them 2
Some of them 3
None of them 4
Q25. Think about your close friends. How many of them do the following?
( Check one box on each row)
|
All of them |
Some of them |
A few of them |
None |
a.Use bad language regularly |
1 |
2 |
3 |
4 |
b.Smoke cigarettes regularly |
1 |
2 |
3 |
4 |
c.Drink beer or alcohol regularly |
1 |
2 |
3 |
4 |
d.Use illegal drugs regularly |
1 |
2 |
3 |
4 |
e.Talk about college and careers |
1 |
2 |
3 |
4 |
f.Talk about classes in school and what they are learning |
1 |
2 |
3 |
4 |
g.Talk about what could be done to improve the neighborhoods and the city |
1 |
2 |
3 |
4 |
Q26. How important do your school friends think it is to:
( Check one box on each row)
|
Very important |
Somewhat important |
Not too important |
Not at all important |
a.Study hard to get good grades |
1 |
2 |
3 |
4 |
b.Talk/hang out with friends |
1 |
2 |
3 |
4 |
c.Participate in class |
1 |
2 |
3 |
4 |
d.Go to college |
1 |
2 |
3 |
4 |
e.Go to one of the best colleges |
1 |
2 |
3 |
4 |
Q27. How many of your close friends…
( Check one box on each row)
|
None
|
Less than half |
About half |
More than half |
All
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0 |
1 |
2 |
3 |
4 |
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0 |
1 |
2 |
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4 |
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0 |
1 |
2 |
3 |
4 |
Q28. Which group of friends has the biggest influence on how you think about school?
( Check one box)
Friends from your neighborhood 1
Friends from school 2
My
neighborhood friends are the same
as my school friends 3
Thank you, please hand in your survey.
File Type | application/msword |
Author | Mike Puma |
Last Modified By | Sylvia Segovia |
File Modified | 2013-03-28 |
File Created | 2012-10-22 |