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### First Semester 11 **th**



### - **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

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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 Programs2 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 Participat ed in an internship 6 Participated in an apprenticeship 7 Developed a senior

-year course
-taking plan 8 Filled out a job application3 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 t o 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 inform ation 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 subm ission 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.