1

First Semester 11th-Grade Instructor Survey

INSTRUCTIONS

This survey asks about college and career instruction provided to your students as part of the Roads to Success 

program. The survey should take about 30 minutes. Your answers are very important to us and will not be 

shared with anyone at your school or community. 

SECTION A: INSTRUCTOR BACKGROUND

1. We would like to confirm your sex. Are you male or 

female?

1 Female

2 Male

2. Are you of Hispanic or [Latino/Latina] origin? 1 Yes

0 No

3. [In addition to learning about your Hispanic 

background, we would also like to know about your 

racial background.] Which of the following choices 

describe your race? You may choose more than one.

(Check all that apply.)

1 White

2 Black/African-American

3 Asian

4 Native Hawaiian or Other Pacific Islander

5 American Indian or Alaska Native

4. What is the highest degree you have earned? 1 Associate’s degree

2 Bachelor’s degree

3 Master’s degree

4 Ph.D., M.D., law degree, or other professional 

degree

5 You do not have a degree

5. Not including this school year, how many years (if any) 

have you taught a high school grade (9-12) or been a 

school counselor?

Whole number

6. Not including this school year, how many years (if any) 

have you taught any grade or been a school counselor?

Whole number

SECTION B: ROADS TO SUCCESS INSTRUCTION

In answering the following questions, please focus on instruction provided in the first half of the school year. 

7. Which of the following topic areas and modules have 

you taught to your class so far this year?

(Check all that apply)

Topic area

Introduction to Roads to Success

Test Preparation

Careers

Job Shadow

Education after High School

Module

[Introduction]

Introduction to the ACT/SAT

ACT/SAT Registration

ACT/SAT Practice Questions

Workforce and Adult Education Tests

Interest Inventory

Career Choice

My Career Research

Work and Values

Completing Job Applications

Introduction to Job Shadow

Informational interview I

Informational Interview II

Creating Resumes I 

Creating Resumes II

Workplace Behavior

Reflection and Thank-you Note

Choosing Courses for Senior Year

Two and Four-Year College Programs
2

Money Matters

Portfolio Review

Choosing a College

College Visits

College Research I

College Research II

College Research III

Choosing a College Major

Letters of Recommendation

Other Education Paths

Evaluating Postsecondary Options

Understanding Credit

Credit Cards

Let’s Go Car Shopping

Paying for a Car

Renting Your First Place

Signing a Lease

Year in Review

8. For each of the modules you have taught, have you 

encountered any challenges difficulties in teaching 

students? If so, what kinds?

[List of each module checked in prior question. Teachers 

to provide a response for each module.]

1 No challenges

2 Lack of materials

3 Lack of student interest

4 Limited instructional time

5 Other (please specify): __________

9. About how minutes per week have you spent on 

Roads to Success instruction?

Whole number

10. Have you provided Roads to Success instruction each 

week of the school year so far?

[If yes, skip the next two questions]

1 Yes

0 No

11. About how many weeks, if any, have you not been 

able to provide Roads to Success instruction?

Whole number

12. Have you “doubled up” instruction in other weeks to 

catch up on Roads to Success material?

1 Yes

0 No

13. What obstacles or challenges have prevented you 

from providing Roads to Success instruction?

1 Lack of preparation time

2 Lack of training on module’s content

3 Competing classroom demands

4 Other (please specify): _____________

14. Have you graded student work produced as part of 

Roads to Success instruction?

1 Yes, Check/check minus or complete/incomplete

2 Yes, Letter or number grade

3 No

15. Do you plan on providing students a final grade for 

their Roads to Success participation?

1 Yes, Pass/fail or complete/incomplete

2 Yes, Letter or number grade

3 No

16. Which of the following specific activities, if any, have 

your students completed as part of your class?

1 Registered for a workforce development test such 

as WorkKeys, ASVAB, or TABE?

2 Prepared a resume

3 Participated in a job shadow

4 Participated in a career fair

5 Participated in an internship

6 Participated in an apprenticeship 

7 Developed a senior-year course-taking plan

8 Filled out a job application
3

9 Completed a career interest inventory

SECTION C: OTHER QUESTIONS

17. Have you taught a specific college and career 

preparation curriculum before (either Roads to Success 

or another curriculum)?

1 Yes

0 No

18. Did you receive training in how to teach Roads to 

Success?

If no, skip the next two questions.

1 Yes

2 No

19. How would you rate the amount of training you 

received to teach Roads to Success?

1 Poor

2 Fair

3 Good

4 Excellent

20. How would you rate the quality of training you 

received to teach Roads to Success?

1 Poor

2 Fair

3 Good

4 Excellent

21. How would you rate the quality of Roads to Success 

materials and instruction guides so far?

1 Poor

2 Fair

3 Good

4 Excellent

22. To what extent have school staff (principal, 

counselors, or other teachers) supported you in 

implementing Roads to Success so far?

1 A great extent

2 Somewhat

3 A little

4 Not at all

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control 

number. The valid OMB control number for this information collection is 1830-NEW. The time required to complete this information collection is estimated 

to average 30 minutes per respondent, including the time to review instructions, gather the data needed, and complete and review the information 

collected. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. 

Department of Education, Washington, DC 20202. If you have comments or concerns regarding the status of your individual submission of this form, write 

directly to: U.S. Department of Education, Office of Career, Technical, and Adult Education, 400 Maryland Avenue, SW, Washington, DC 20202-7100.