Attachment A-1. District Staff Survey 

Dear District Superintendent or Curriculum and Instruction Director,

The Regional Education Lab Southwest (REL Southwest) is studying changes in student 

mathematics course-taking and course failures, as well as changes in district mathematics course 

offerings and diploma plan placement, that occur after implementation of Texas House Bill 5 (HB 

5)—the Foundation High School Program. One aspect of this study focuses on how districts are

responding to the provisions of House Bill 5. We greatly appreciate your participation. Please have 

the person who is most knowledgeable about how your district is responding to the new Texas 

high school graduation requirements with regard to endorsements offered, courses added, and 

information dissemination to parents complete this survey.

The questionnaire for this study will take approximately 15 minutes to complete. Its focus is on

the new high school graduation plans, including the establishment of courses to meet the new

endorsement requirements.

This survey is voluntary. You may decide to not take part without penalty or loss of any benefits you 

are otherwise entitled to. All responses will be confidential; no individual or district will be

identified. Only aggregated results will be reported.

Education Sciences Reform Act of 2002, Title I, Part E, Section 183, prohibits disclosure of individually 

identifiable information as well as making the publishing or communicating of individually identifiable 

information by employees or staff a felony. 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 school, district, or individual. Any willful disclosure of such 

information for nonstatistical purposes, except as required by law, is a class E felony.

If you are interested in reading a summary of the results from districts around the state, please let

us know and we will be happy to send you a report at the end of the project.

To participate in the survey, go to the following site:

<<unique link>>

If you are unable to complete the questionnaire, please forward this email to the appropriate

person at the district who might be able to answer these questions.

Your responses are very much appreciated.

If you have any comments or concerns about this study, please contact Deborah Van Kummer,

Research Assistant, at deborah.vankummer@sedl.org. If you have questions or concerns about 

your rights as a survey participant, or to offer your input, you may contact Ethical & Independent 

Review Services, the Institutional Review Board (IRB), who reviewed this study for your rights, at 

8100-472-3241 or by email at subject@eandireview.com.

You may want to print a copy of this to keep for your records.

Thank you for your contribution to this important effort. 
Sincerely,

REL Southwest
Thank you for agreeing to participate in the survey!

Complete the questionnaire by marking your responses asindicated on the web page. When you

are done, simply click “submit” on the last page. You will have to complete the survey in one

sitting; there is no option to save and return at a later time. By completing this survey, you agree

to participate in the research study.

______________________________________________________________________________

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 1850-xxxx. Public reporting burden for this collection of information is estimated to average 15 

minutes/hours per response, including time for reviewing instructions, searching existing data sources, gathering and 

maintaining the data needed, and completing and reviewing the collection of information. 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 (Chris Boccanfuso at Chris.Boccanfuso@ed.gov directly. [Note: 

Please do not return the completed instrument, form, application or survey to this address.]
1. Please indicate which high school graduation endorsements will be offered in your district. 

(Select in all that apply)

⃝ Arts & Humanities

⃝ Business & Industry

⃝ Public Service

⃝ STEM

⃝ Multidisciplinary

2. Fill in the number of schools in your district in which each endorsement will be offered.

Endorsement Number

Arts & Humanities

Business & Industry

Public Service

STEM

Multidisciplinary

3. Which, if any, of the new graduation plans are students in your district being automatically 

placed in? (Select one)

⃝ Foundation

⃝ Foundation Plus Endorsement

⃝ Distinguished

⃝ None

3a. If students are being automatically placed into a graduation plan, what is the first point at 

which they can formally choose a different graduation plan? (Select one)

⃝ Freshman year

⃝ Sophomore year

⃝ Junior year

⃝ Senior year
4. Please list the advanced mathematics courses being offered by the schools in your district. An

advanced mathematics course is a mathematics course that fulfills the third and fourth 

mathematics course requirements under the new Foundation High School Program (HB 5 

graduation requirements).

Please write the PEIMS service codes, course titles, and the number of schools in your district in 

which each advanced mathematics course will be offered on the lines below. 

PEIMS Service Code Advanced Mathematics Course Title Number of 

schools

5. How are you communicating with parents about the new high school graduation 

requirements? (Select all that apply)

⃝ Brochure/Flyer

⃝ Webinar

⃝ District webpage

⃝ Parent meetings

⃝ Student handbook

⃝ TEA Graduation Toolkit

⃝ Video

⃝ Counselors

⃝ Teachers

⃝ Site-based decision making committee

⃝ Other (please describe):____________________________________

6. Later this year we will be recruiting high schools to participate in a study looking at changes 

to the mathematics course requirements for high school graduation being implemented under 

Texas House Bill 5. Participating schools will be asked to distribute informational materials 

describing the changes to the high school graduation mathematics requirements next year (late 

February 2016). Do you think high schools in your district would be interested in participating in 

our study?

⃝ Yes

⃝ No

7. Is there anything else that you would like to share with us about how your district is 

responding to the new graduation requirements enacted under House Bill 5? (Please write your 

comments in the box below) 
Thank you!