OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Contents ▌pg. i

Appendix D. Student Survey
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Contents ▌pg. ii

Table of Contents

Survey Source Key .......................................................................................................................................1

Introduction...................................................................................................................................................2

Educational Expectations..............................................................................................................................4

College Plans ................................................................................................................................................4

Academic Preparation...................................................................................................................................6

College Preparation Experiences..................................................................................................................8

Background Information...............................................................................................................................9

Concluding Remarks...................................................................................................................................11
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-1

Survey Source Key

 College Board, Completing the SAT Questionnaire 

 Dallas Independent School District 2012 Senior Exit Survey (reproduced in the SDP 

Summer Melt Handbook)

 HSLS: High School Longitudinal Survey of 2009, Student Baseline

 HSLS Follow-Up: High School Longitudinal Survey of 2009, Student First Follow-up

 HSLS: High School Longitudinal Survey of 2009, Parent Survey
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-2

Introduction

Your school’s GEAR UP program is participating in an important study to better understand how 

GEAR UP works in high schools and to increase the number of students who enroll in and 

complete college. The U.S. Department of Education is sponsoring this study and has hired Abt 

Associates and Survey Research Management to conduct this survey. 

You do not have to complete this survey. Your participation is voluntary and you may choose 

not to answer a question or to stop the survey at any point. You can participate in GEAR UP 

even if you do not complete the survey. 

Protecting your privacy is very important to us. Your name will not be included in any reports or 

data produced by the study. We will not share information from this survey that identifies you to 

anyone outside the study team, except as required by law.

We know your time is valuable and thank you for your participation in this survey!

SC1. Are you willing to take this survey?

 Yes

 No [SKIP to SC4]

SC2. This summer and next fall we will be reaching out to a select group of students and their 

families to offer help with the final steps in the college-going process, and to help you work 

through any challenges that come up in making your postsecondary plans happen. 

Would you like to be entered into the lottery to participate in this program?

 Yes

 No [SKIP to SC4]

Source: Dallas Independent School District 2012 Senior Exit Survey (adapted in tracked changes)

We are asking you to complete a short survey about your plans for college and 

about activities related to college planning.

The survey should take about 15 minutes to complete.

Your answers could help improve the college advising and support services

provided in GEAR UP programs across the country. 
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-3

SC3. So that we can get in touch with you after you graduate, please provide us with your cell 

phone number.

This information will be kept in secure and protected data files separate from the responses you 

provide. A study generated unique identification number will your survey responses to your contact 

information. Your cell phone number will be destroyed within 30 days of the completion of the study.

[SKIP to Q1]

Source: Dallas Independent School District 2012 Senior Exit Survey (adapted in tracked changes)

SC4. Thank you for your time.

[SUBMIT and EXIT]

Per the policies and procedures required by the Education Sciences Reform Act of 2002, Title I, Part E, Section 183, responses to this data 

collection 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 program, district, or individual. Any willful disclosure of such information for nonstatistical purposes, except 

as required by law, is a class E felony.

Paperwork Burden Statement: 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 xxxxxxxx. 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 voluntary. If you have comments or concerns regarding the status of your individual submission of this form, application or survey, 

please contact (National Center for Education Evaluation/Institute of Education Sciences U.S. Department of Education, 555 New Jersey Avenue, 

SW Room 502i, Washington, DC 20208) directly. (Note: Please do not return the completed instrument, form, application or survey to this 

address.)
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-4

Educational Expectations

First, please answer some questions about your expectations for life after high school.

1. As things stand now, how far in school do you think you will actually get? 

 Less than high school completion

 Complete a high school diploma, GED or alternative high school credential

 Complete a certificate or diploma from a school that provides occupational training

 Complete an Associate's degree

 Complete a Bachelor's degree

 Complete a Master’s degree

 Complete a Ph.D., M.D., law degree, or other high level professional degree

 I don’t know

Source: HSLS for question, HSLS follow-up for answer choices (Change You to I)

2. Whatever your plans, do you think you have the ability to complete a Bachelor's degree?

 Definitely

 Probably

 Probably not

 Definitely not

Source: HSLS

College Plans

Please answer the following questions about the college application process and your plans for 

college.

3. How many colleges did you apply to?

____ Number

Source: Author developed

Instructions: Throughout this survey when you see the term ‘college’ please think 

about any school that offers degrees or certificates to students who have completed 

high school, such as a community or technical college, a state university, a private 

liberal arts college, or a training institute.
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-5

4. Which of the following activities do you expect to be doing in the fall of 2017

Yes No

I don’t 

know

a. Continuing your education after high school   

b. Working [SKIP TO Q6]   

c. Serving in the military [SKIP TO Q6]   

d. Starting a family or taking care of your 

children [SKIP TO Q6]

  

e. Attending high school or a GED completion 

course [SKIP TO Q6]

  

Source: HSLS Follow-up, adapted

5. Which college are you most likely to attend during the 2017-2018 school year?

 [Dropout with list of states]

o Dropdown with list of schools with NCES IPEDS number 

 [text box for students who couldn’t find their college]

 I haven’t decided yet

Source: Author developed
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-6

Academic Preparation

The next set of questions asks about your experiences in school.

6. What grade were you in when you took Algebra I? (If you have taken it more than once, 

answer for the most recent time you took it. If you are currently taking Algebra I, choose 

your current grade.) 

 8th grade or earlier

 9th grade

 10th grade

 11th grade

 12th grade

 I have not taken Algebra I yet

Source: HSLS Follow-up

7. Including this year, how many years of math did you take during high school?

 One year

 Two years

 Three years

 Four or more years

Source: HSLS

8. Are you currently enrolled in any honors classes?

 Yes

 No

 I don’t know

Source: Adapted from HSLS. Was originally a parent question. Added I don’t know option.

9. Have you taken any Advanced Placement (AP) OR International Baccalaureate (IB) courses? 

Include any courses you are taking now.

 Yes 

 No [SKIP TO Q11]

 I don't know [SKIP TO Q11]
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-7

Source: Adapted from HSLS Follow-up. Merged AP and IB questions into one.

10. Have you already taken either of the following tests? 

Yes No

I don’t 

know

a. Any Advanced Placement (AP) test   

b. Any International Baccalaureate (IB) test   

Source: HSLS Follow-up, adapted

11. Other than AP and IB courses, have you taken any high school courses for college credit/did 

you take any high school courses for college credit when you were in high school? (Include 

any courses for college credit that you are taking now.) 

 Yes

 No

 I don’t know

Source: HSLS Follow-up. (Changed You to I)

12. Indicate your cumulative grade point average (GPA) for all academic subjects as of the end 

of your junior year in high school (last year). 

 A+ (97-100)  C+ (77-79)

 A (93-96)  C (73-76)

 A– (90-92)  C– (70-72)

 B+ (87-89)  D+ (67-69)

 B (83-86)  D (65-66)

 B– (80-82)  F (below 65)

Source: College Board SAT Survey, adapted

13. Have you already taken the following tests?

Yes No

I don’t 

know

a. PSAT or PLAN   

b. SAT or ACT   

c. ACCUPLACER or COMPASS   

Source: HSLS Follow-up, adapted
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-8

College Preparation Experiences

These next questions ask about some of your college preparation experiences.

14. Since the beginning of last school year (2015-2016), that is, your junior year, how many

times has a college counselor/advisor at your high school discussed the following with you:

0 times 1 time 2 times 3 times 4 times 5 or more 

times

a. Graduation rates,

employment rates, and 

other student outcomes at 

different colleges

     

b. Admissions requirements 

(such as SAT/ACT scores, 

transcripts, and 

recommendations) for 

different types of colleges

     

c. Timelines for applying to 

college      

d. How to complete the 

Common Application      

e. Your family’s options for 

paying for college      

f. How much you and your 

family will have to pay for 

college if you get financial 

aid

     

g. How to complete the 

FAFSA (Free Application 

for Federal Student Aid) 

form

     

Source: Author developed
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-9

15. Have you gotten information on financial aid in any of the following ways?

Yes No

I don’t 

know

a. Talked to parent/guardians, family, or friends 

about financial aid   

b. Talked one-on-one with staff at your high 

school (e.g., college advisor, teacher or 

guidance counselor)

  

c. Researched financial aid options on the internet   

d. Went to an informational meeting held at your

high school   

Source: Adapted from HSLS. Question is originally from HSLS parent survey. Adapted subquestions to teenager respondent.

Background Information

These next questions ask you about your family and you. 

16. What is your gender? 

 Male 

 Female 

Source: Adapted HSLS was on parent survey

17. Are you Hispanic or Latino/Latina? 

 Yes 

 No 

Source: Adapted HSLS was on parent survey

18. What is your race? (Check all that apply.)

 White 

 Black or African American 

 Asian 

 Native Hawaiian or other Pacific Islander 

 American Indian or Alaska Native 
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-10

Source: HSLS

These next questions are about your parents or guardians. If you live in more than one 

household, answer about the parents or guardians you live with most of the time. Please choose 

one parent to begin.

19. What is this parent’s or guardian’s relationship to you?

 Biological mother 

 Biological father 

 Adoptive mother 

 Adoptive father 

 Stepmother 

 Stepfather 

 Other female guardian 

 Other male guardian 

Source: HSLS, adapted

20. What is the highest level of education [he/she] has completed?

 Less than high school 

 High school diploma or GED 

 Completed a certificate or diploma from a school that provides occupational training

 Completed some college but no degree

 Associate’s degree 

 Bachelor’s degree 

 Master’s degree 

 Educational Specialist diploma 

 Ph.D., M.D., law degree, or other high level professional degree 

 I don’t know

Source: HSLS, adapted

21. Do you have another parent or guardian in the same household as you? 

 Yes 

 No [SKIP to CONCLUSION]
OMB Support Statement Student Messaging in GEAR UP

Abt Associates Inc. Appendix D. Student Survey ▌pg. D-11

Source: HSLS

22. What is this parent’s or guardian’s relationship to you?

 Biological mother 

 Biological father 

 Adoptive mother 

 Adoptive father 

 Stepmother 

 Stepfather 

 Other female guardian 

 Other male guardian 

Source: HSLS, adapted

23. What is the highest level of education [he/she] has completed?

 Less than high school 

 High school diploma or GED 

 Completed a certificate or diploma from a school that provides occupational training

 Completed some college but no degree

 Associate’s degree 

 Bachelor’s degree 

 Master’s degree 

 Educational Specialist diploma 

 Ph.D., M.D., law degree, or other high level professional degree 

 I don’t know

Source: HSLS, adapted

Concluding Remarks

Thank you for completing the survey! If you have any additional questions please do not 

hesitate to contact a member of the study team at: xxxx@abtassoc.com or toll-free at XXXXXX-XXXX.