### Instructional Log for Ramp

- Up Workshop

Purpose. We would like your feedback on the workshop you taught today and some information about the advisories that you have taught so far this year. Your opinions are useful for improving the quality of the Ramp

- Up program.

Confidentiality. Regional Educational Laboratory Midwest will keep all collected data
confidential. Per the policies and procedures required by the Education Sciences Reform Act of 2002, Title I, Part E, Section 183, responses to this data colle ction will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific individual. We will not provide information that identifies you to anyone outsi de the study team, except as required by law. Any willful disclosure of such information for nonstatistical purposes, without the informed consent of the respondent, is a class E felony.

Risks. There are no known risks related to participating in this sur vey.

Voluntary Participation. You have the right to discontinue your participation in this survey at any time without consequences. We hope you will answer all the questions , but i f there is a question you do not wish to answer, simply skip it.

Procedu re. Completion of each log entry will take no longer than 10 minutes . If you complete all five logs, you will receive a $25 gift card for your participation

.

Contact Information. If you have questions or concerns about this study , plea s e contact Jim Lindsay at jlindsay@air.org or 630

- 649

- 6591

. If you have concerns or questions about your rights as a participant , contact the c hair of AIR’s Institutional Review Board (which is responsible for the protection of study participants) using the following contact information:

E

- M ail: IRBChair@air.org
Phone: 1

- 800

- 634

- 0797 (toll free)
Mail: IRB Chair
c/o AIR
1000 Thomas Jefferson Street NW Washington, DC 20007

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 1850

- XXXX, OMB expiration date is XXXX, XX , 201 7

. The time required to complete this information collection is estimate d to be 1 0 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 t his 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, Institute of Education
Science s, 555 New Jersey Avenue, NW, Washington, DC 20208.Background Information

1. What is your current position at this school? Check all that apply.

 Teacher

 Counselor

 Dean

 Principal

 Assistant principal

 Other school staff

2. What is the name of your school ? [text box ]

Today’s Ramp

- Up Workshop

The following questions ask about the Ramp

- Up workshop that you taught today.

3. Did you teach or assist in teaching a Ramp

- Up workshop today?

 Yes [continue to q4]

 No [skip to q19]

4. What topic ( s ) did you cover in today’s workshop? [text box]

5. How many students actually attended the workshop? [ drop down box]

6. What percentage of your students attended the workshop ? [ drop down box ]

7. In w hat grade s are the students who attended the workshop that you taught today ? C heck all that apply

.

 9th grade

 10th grade

 11th grade

 12th grade8. How long did today’s workshop last?

 Less than 30 minutes

 30

– 45 minutes

 46

– 60 minutes

 More than 60 minutes

9. Select the college

- readiness pillars that were discussed during toda y’s workshop? Check all that apply

.

 Academic Readiness

 Admissions Readiness

 Career Readiness

 Financial Readiness

 Personal and Social Readiness

10. Did you adapt the instructional materials to suit the needs of your workshop?

 Yes [continue to q11]

 No [skip to q12]

11. Please describe how you adapted the instructional materials to suit the needs of your workshop. [text box]

12. What percentage of students who attended today’s workshop were actively engaged in the workshop’s activities ?

 Less than 25 percent

 25 percent to 50 percent

 51 percent to 75 percent

 More than 75 percent

 I do not know.

13. I had enough time to prepare lesson content prior to teaching today’s workshop.

 Strongly d isagree

 Disagree

 Agree

 Strongly a gree14. I had enough information about the college selection and enrollment process to teach today’s

workshop

.

 Strongly d isagree

 Disagree

 Agree

 Strongly a gree

15. I ha d enough information about the knowledge and skills needed to succeed in college to
teach today’s workshop

.

 Strongly d i sagree

 Disagree

 Agree

 Strongly agree

16. What worked well in today’s workshop? [text box]

17. What could be improved about today’s workshop? [text box]

18. If you have any additional comments about today’s workshop, please enter them here: [ text box]

Weekly Ramp

- Up Advisories

The following questions ask about the weekly Ramp

- Up advisories taught so far this year.

19. Have you taught at least one Ramp

- Up advisory this school year?

 Yes [continue to q20 ]

 No [ end survey]

20. Are you assigned to teach a ninth

- grade Ramp

- Up advisory?

 Yes [continue to q21 ]

 No [skip to q 22]21. Which lessons have you taught so far this year to ninth graders ? Check all that apply. [insert

names of each lesson taught to ninth graders]

22. Are you assigned to teach a 10 th

- grade R amp

- Up advisory?

 Yes [continue to q23 ]

 No [skip to q 24]

23. Which lessons have you taught so far this year to 10 th graders ? Check all that apply. [insert names of each lesson taught to 10 th graders]

24. Are you assigned to teach an 11 th

- grade Ramp

- Up advisory?

 Yes [continue to q25 ]

 No [skip to q 26]

25. Which lessons have you taught so far this year to 11 th graders ? Check all that apply. [insert names of each lesson taught to 11 th graders]

26. Are you assigned to teach a 12 th

- grade Ramp

- Up advisory?

 Yes [continue to q27 ]

 No [skip to q 28]

27. Which lessons have you taught so far this year to 12 th graders ? Check all that apply. [insert names of each lesson taught to 12 th graders]

28. On average, w hat percentage of students scheduled to attend your weekly advisory have
attend e d every session so far ?

 Less than 25 percent

 25

– 50 percent

 51

– 75 percent

 More than 75 percent

 I do not know.29. On average, how long have the weekly advisory sessions you’ve taught so far this year

lasted?

 Less than 20 minutes

 20

– 29 minutes

 30 minutes

 I do not know.

30. So far this year, how often have you adapt ed the instructional materials to suit the needs of your advisory ?

 Never

 Rarely

 Sometimes

 Often

 Always

31. On average, what percentage of students in your advisory actively engage in the advisory’s
activities ?

 Less than 25 percent

 25

– 50 percent

 51

– 75 percent

 More than 75 percent

 I do not know.

32. If you have any additional comments about the Ramp

- Up advisories , please enter them here: [text box]

Thank you for completing this log!