OMB Control Number XXXX-XXXX (Exp XX/XX)

REL Midwest Implementation Study of the Ramp-Up to Readiness Program—1

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. REL 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 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 individual. We will not provide information that identifies you to anyone outside 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 survey. 

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 if there is a 

question you do not wish to answer, simply skip it. 

Procedure. 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, please 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 chair of AIR’s Institutional Review Board (which is 

responsible for the protection of study participants) using the following contact information:

E-Mail: 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 XXXX.XXXX, OMB expiration date is XXXX, XX, 

2014. The time required to complete this information collection is estimated to average 15 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, Institute of 

Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208. 
OMB Control Number XXXX-XXXX (Exp XX/XX)

REL Midwest Implementation Study of the Ramp-Up to Readiness Program—2

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 what grades are the students who attended the workshop that you taught today? 

Check all that apply.

• 9th grade

• 10th grade

• 11th grade

• 12th grade

8. 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 today’s workshop? Check 

all that apply.

• Academic Readiness

• Admissions Readiness
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REL Midwest Implementation Study of the Ramp-Up to Readiness Program—3

• Career Readiness

• Financial Readiness

• Personal/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 was actively engaged in 

the workshop’s activities?

• Less than 25%

• 25–50%

• 51–75%

• More than 75%

• I do not know.

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

• Strongly Disagree 

• Disagree

• Agree 

• Strongly Agree 

14. I had enough information about the college selection and enrollment process to teach 

today’s workshop.

• Strongly Disagree

• Disagree 

• Agree

• Strongly Agree

15. I had enough information about the knowledge and skills needed to succeed in college 

to teach today’s workshop.

• Strongly disagree 

• 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]
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REL Midwest Implementation Study of the Ramp-Up to Readiness Program—4

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 q22]

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 10th-grade Ramp-Up advisory?

• Yes [continue to q23]

• No [skip to q24]

23. Which lessons have you taught so far this year to 10th graders? Check all that apply.

[insert names of each lesson taught to 10th graders]

24. Are you assigned to teach an 11th-grade Ramp-Up advisory?

• Yes [continue to q25]

• No [skip to q26]

25. Which lessons have you taught so far this year to 11th graders? Check all that apply.

[insert names of each lesson taught to 11th graders]

26. Are you assigned to teach a 12th-grade Ramp-Up advisory?

• Yes [continue to q27]

• No [skip to q28]

27. Which lessons have you taught so far this year to 12th graders? Check all that apply.

[insert names of each lesson taught to 12th graders]

28. On average, what percentage of students scheduled to attend your weekly advisory has

attended every session so far?

• Less than 25%

• 25–50%

• 51–75%

• More than 75%

• I do not know.
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REL Midwest Implementation Study of the Ramp-Up to Readiness Program—5

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 adapted 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 engages in the 

advisory’s activities?

• Less than 25%

• 25–50%

• 51–75%

• More than 75%

• 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!