# AP **PENDIX A**

**TEA CHER**  **AS SIGNMENT DA**  **TA REQUEST** 

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# A. 3

**Sheila Heaviside**

Survey Director 1100 1st Street, NE, 12th Floor

Washington, DC 20002

- 4221

Telephone (202) 484

- 9220

Fax (202) 863

- 1763

www.mathematica

- mpr.com



# [DATE]

Dear [ School Contact] :

We would like to thank your school for participating in the evaluation of d ata

- d riven

i nstruction sponsored by

the U.S. Department of Education and conducted by Mathematica Policy

Research and its partners . This study will provide valuable information on how data

- driven

instruction is implemented in schools and the impact of high quality data

- driven instruction on

student achievement and other outcomes

.

We are requesting data for fourth and fifth grade teachers in study sch ools in order to identify

a sample of teachers who will be asked to complete a study survey , and to examine movement of

teachers between the start of the study in fall 2014 and when the survey will be administered in

spring 2016.

The attached teacher enum eration form and instructions indicate which teachers should be

included and information we would like for each teacher. You can return the data either b y posting

an electronic file to our secure website or b y s ending the hard cop y lists via a prepaid Fede ral

Express packet provided.

The staff list y ou provide will be used only for sampling purposes for this study

.

Thank y ou very

much for y our assistance with this data request. A member of our study team

will contact y ou in the next week to determine if yo u have an y questions about this request and to

whom y ou have delegated the task of completing the form . You can reach me at 202

- 484

- 3096 or sheaviside@mathematica

- mpr.com

. We greatl y appreciate your support for this important study

.

Sincerely

,



# Sheila H eaviside

Survey Director

**Public Burden Statement**

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless su ch collection displays

a valid OMB control number. Public reporting burden for this collection of information is estimated to average 15 minutes per response. The

obligation to respond to this collection is voluntary. Send comments regarding the burden estimate or any other aspect of this collection of

information, including suggesti ons for reducing this burden, to the U.S. Department of Education, Washington, DC 20202. I f y ou have comments or

concerns regarding the content or the status of your individual submission of this form, write directly to: U.S. Department of Education, I nst itute of

Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208.



# An Affirmative Action/Equal Opportunity Employer

# A. 4**[ S** **C H** **O O** **L N** **A M** **E o** **r I** **D ]** **L i** **n e** **T e** **a c** **h e** **r '** **s E** **m a** **i l** **A d** **d r** **e s** **s G** **r a** **d e** **s T** **a u** **g h** **t S** **u b** **j e** **c t** **s T** **a u** **g h** **t T** **e a** **c h** **i n** **g S** **t a** **t u** **s a** **t t** **h i** **s S** **c h** **o o** **l P** **r i** **o r** **Y e** **a r** Pleaseprovideanemailaddressthattheschoolusestocontactthisteacher.Enterthenumericcodethatcorrespondstothegrade(s)taughtbythisteacher.Enterthenumericcodethatcorrespondstothesubject(s)taughtbythisteacher.Enterthenumericcodethatcorrespondstotheteacher'sstatusatthisschool.Didthisteacherteachatthisschoolduringthepriorschoolyear(2014-2015)?FirstLastEmailAddress1-4th2-5th3-Both1-Math2-Reading3-Both1-Full-time2-Part-time1-Yes2-No12345678910Responsestothisdatacollectionwillbeusedonlyforstatisticalpurposes.Thereportspreparedforthisstudywillsummarizefindingsacrossthesampleandwillnotassociateresponseswithaspecificdistrictorindividual.Wewillnotprovideinformationthatidentifiesyou,teachers,principals,oryourdistricttoanyoneoutsidethestudyteam,exceptasrequiredbylaw.OMBNo.XXXX:ApprovalExpiresXX/XX/20XXU.S.DEPARTMENTOFEDUCATION**T e** **a c** **h e** **r '** **s N** **a m** **e**Pleaselistalloftheteacherswhoteach4thor5thgradeatthisschoolduringthisschoolyear(2015-2016).Pleaseprovidefirstandlastnameandanemailaddress.**N o** **t i** **c e** **o f** **C o** **n f** **i d** **e n** **t i** **a l** **i t** **y**

# A. 5 

# EVALUATION OF DATA

**- DRIVEN INSTRUCTION** 

**GUIDELINES FOR SENDING**  **TEACHER DATA FILES** 

Please use one of the two methods below to return the teacher assignment list to Mathematica.

**A**

**. Upload Electronic Files to a Secure Website** 

1. Go to https://www.xxx.org/upload using an Internet browser ( for example, Microsoft

Explorer). When prompted, use the following login information:

Username: XXX

Password: XXX

Domain Name: XXX

Note: Username and password are case sensitive.

2. Click the BROWSE button and select the file y ou wish to transfer.

3. Click the UPLOAD button to begin the transfer process. Once a file is uploaded, it cannot

be downloaded or accessed by anyone other than an authorized member of the study team.

4. If the file name is not uniq ue, y ou will receive a message indicating that the “file already

exists.” If this occurs, please rename your file and upload again.

5. Close the browser once the upload is complete.

6. If your file is password protected, please call [ Name ] at [ phone ] with the password. For

security reasons, please do not send the password by email.

**B**

**. Federal Express**  **( Paper Lists, Diskettes**  **CD**

**- ROM**  **s , DVD**  **s )** 

1. Use the enclosed prepaid labels and send your package via Federal Express to

Mathematica. Please write your retur n address information and the type of packaging you

are using on the Federal Express label.

2. Affix the provided “DO NOT X

- RAY; DO NOT BEND” label to the package.

3. If you would like Mathematica to provide other packaging material appropriate for the type

of data list y ou are sending, please call [ Name ] at [ phone ].

4. Keep a copy

of the information y ou send for your records.

**If you have additional questions about the request or any of the instructions above, please call**

**(Name) at XXX**

**- XXX** 

**- XXXX or email XXXX.** 

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