# Evaluation of the DC Opportunity

**Scholarship Program Elementary**  **School (Grades**  **4 -** **5 )**  **Student Questionnaire Spring 20**  **13**

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 xxxx-xxxx. Public reporting burden for this collection is estimated to average **15 m inutes**  per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. Com pletion of this survey is mandatory. SOAR Act Sec. 3009(a)(3)(C). . Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the U.S. Department of Education, 400 Maryland Avenue, S.W., LBJ, Room 2E117, Washington, DC 20210-4537 or send electronically through the Federal eRulemaking Portal at http://www.regulations.gov by selecting the Docket ID number. **OM B #:**  **Expiration Date:** Elem entary School Student Questionnaire - Spring 2013 

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## Please answ**er all the questions. Part 1: A** **bout You This first section asks questions about y** **ou .**  Q1. Are you a .... (Previous DC Choice Study survey) **(** **Check one)** Boy or ................................ ............... 

##  1 Girl ? ................................ ................... 

##  2 Q2 . How often do you read books that are not assigned by your teacher? **(** **Check one)** (Previous DC Choice Study survey) Every day ................................ .......... 

##  1 Most days ................................ .......... 

##  2 Som e days ................................ ........ 

##  3 Never ................................ ................. 

##  4 Q3 . How far do yo u expect to go in school? **(** **Check one)** (Question is from Previous DC Choice Study survey ; response categories are from HSLS, 2009: First Follow -up ) Less than high school completion ................................ ................................ ................. 

##  1 Complete a high school diploma, GED or alternative high school credential ............... 

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

##  3 Complete an Associate’s degree ................................ ................................ .................. 

##  4 Complete a Bachelor’s degree ................................ ................................ ...................... 

##  5 Complete a Master’s degree ................................ ................................ ......................... 

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

##  7 Q4. During this year, have you done any of the following? **(** **Check yes or no on each row)** (Previous DC Choice Study survey) Yes No a. Participated in groups or activities at your church (like choir or youth group) .............................. 

##  1 

##  2 b. Participated in a team or club (like little league or girl scouts/boy scouts) in your community ..... 

##  1 

##  2 c. Participated in a team or club (like sports, music, or dance) at your school ........................... 

##  1 

##  2 d. Participated in a community service activity or volunteer work at your school or in your community ................................ ..................... 

##  1 

##  2 e. Gone to religious services ............................. 

##  1 

##  2Elem entary School Student Questionnaire - Spring 2013 

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Q5 . On a regular school day, how long are you at home after school with no adult there? **(** **Check one)** (Previous DC Choice Study survey) None ................................ ..................... 

##  0 Less than 1 hour ................................ .. 

##  1 1 -2 hours ................................ .............. 

##  2 2-3 hours ................................ .............. 

##  3 More than 3 hours ................................ 

##  4 Q6 . Do you work hard at school? ( new item ) **(** **Check one)** Yes ................................ ....................... 

##  1 No ................................ ......................... 

##  2 Q7 

### . How important are each of the following in causing you to want to work harder in school ? **(** **Check one box on each row)** ( Bishop, CAHRS WP03-06 Item 15, revised ) Very im portant Som ewhat

im portant Not too

im portant Not at all

im portant Pressure from m y parents ................................ 

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##  4 Pleasing m y parents by getting good grades ................................ ................................ 

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##  4 Teacher expectations ................................ ......... 

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##  4 Pleasing m y teacher ................................ ........... 

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##  4 Encouragement from my teachers ..................... 

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##  4 Learning the material ................................ ......... 

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##  4 Interest in the subject ................................ ......... 

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##  4 Keeping up with m y friends ................................ 

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##  4 Getting a better job ................................ ............. 

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##  4 Getting into college ................................ ............ 

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##  4 Pressure from m y friends ................................ 

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##  4 Not embarrassing m y family .............................. 

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##  4Elem entary School Student Questionnaire - Spring 2013 

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## Part 2: A**bout Your School and Classes**  **This section asks questions about yo**  **ur school and classes** **, support from teachers and other a** **dults in the school and other students’ a** **ttitudes .**  Q8 . Do you agree or disagree with these statements about your school? **(** **Check one box on each row)** (Previous DC Choice Study survey) Agree strongly Agree Disagree Disagree strongly Students are proud to go to this school ....... 

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##  4 Students at this school have a lot of opportunities to learn ................................ .... 

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##  4 Rules of behavior are strict .......................... 

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##  4 I don’t feel safe ................................ ............. 

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##  4 People at m y school are supportive ............. 

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##  4 I feel alone at m y school .............................. 

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##  4 I enjoy going to school ................................ . 

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##  4 Q9 . Did the following ever happen to you at school this year? **(** **Check one box on each row)** (Previous DC Choice Study survey) Never Once or

twice 3 tim es or

more a. Had something stolen from your desk, locker, or other place ................................ ............... 

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##  3 b. Been forced by other kids to give them money or m y stuff ................................ .................... 

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##  3 c. Been offered drugs ................................ .................. 

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##  3 d. Been physically hurt by another student ................. 

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##  3 e. Been threatened with physical harm ....................... 

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##  3 f. Seen anyone with a real or toy gun or knife at school ................................ ................................ .. 

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##  3 g. Been bull ied at school ................................ ............. 

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##  3 h. Been called a bad name ................................ .......... 

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##  3Elem entary School Student Questionnaire - Spring 2013 

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Q 10 . Do you agree or disagree with these statements about the teachers and other adults at yo ur school? **(** **Check one box on each row)** (Previous DC Choice Study survey) Agree strongly Agree Disagree Disagree strongly 

### At**my school, there is a teacher or**  **some other adult who...** a. l istens to me when I have something to say ................................ ................................ 

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##  4 b. really cares about me ................................ ...... 

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##  4 c. believes I will be a success ............................. 

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##  4 d. always wants me to do m y best ....................... 

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##  4 e. tells me when I do a good job .......................... 

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##  4 f. notices when I’m not there ............................... 

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##  4 g. talks to me about problems I have at hom e or with m y friends ................................ 

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##  4 h. motivates me to work hard .............................. 

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##  4 Q 11 . During the current school year (2012-2013), have teachers and other school staff provided you with support? If they did, was it helpful ? **(** **Check two**  **box es**  **on each row)** (NLTS 2012, Baseline Interview for Youth) Yes No Very

Helpful Som ewhat

Helpful Not

Helpful a. Extra help before or af ter school in academic subjects? ................................ 

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##  3 b. Academic instruction on weekends? ................................ ............................. 

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##  3 Q 12 . Do you agree or disagree with these statements about the students at yo ur school? **(** **Check one box on each row)** (Previous DC Choice Study survey) Agree strongly Agree Disagree Disagree strongly 

### At**my school, students...**  a. behave well with the teachers .................... 

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##  4 b. often don’t do their homework .................... 

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##  4 c. often make fun of each other...................... 

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##  4 d. often disrupt class ................................ ...... 

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##  4 e. who misbeh ave often get away with it ........ 

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##  4Elem entary School Student Questionnaire - Spring 2013 

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Q13 . What overall grade would you give your school? **(** **Check one)** (Previous DC Choice Study survey) A- Excellent ................................ ........ 

##  1 B-Good ................................ .............. 

##  2 C- Fair ................................ ................ 

##  3 D- Unsatisfactory ................................ 

##  4 F- Failing ................................ ............ 

##  5 Q 14 . During this year, have you taken classes in ? **(** **Check yes or no on each row)** (Previous DC Choice Study survey) Yes No a. Art, music, or dance lessons ................ 

##  1 

##  2 a. Foreign language classes ..................... 

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##  2 b. Religion ................................ ................. 

##  1 

##  2 c. Sports exercise or gymn astics ............. 

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##  2 Q15 . How much do you agree or disagree with the following statem ents about your teacher? Remember, your teacher and your principal will not see any of the answers you provide. Your teacher... **(**  **Check one box on each row)** (HSLS, 2009 – Baseline) Agree strongly Agree Disagree Disagree strongly a. Values and listens to students’ ideas ............

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##  4 b. Treats students with respect..........................

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##  4 c. Treats every student fairly .............................

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##  4 d. Thinks every student can be successful ................................ ......................

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##  4 e. Thinks mistakes are okay as long as all students learn ................................ ...........

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##  4 f. Treats som e kids better than other kids ................................ ................................

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##  4 g. Makes learning interesting .............................

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##  4 h. Treats males and females differently ............

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##  4 i. Makes things easy to understand ..................

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##  4 Q 16 . On average, how many minutes do you spend doing homework per day? **(** **Check one)** ( Adapted Bishop, CAHRS WP03-06 Item 9 ) 0 minutes ................................ ........... 

##  0 1 to 10 mi nutes ................................ . 

##  1 11 to 20 minutes ............................... 

##  2 

### 21 to 30 minutes ............................. 

##  3 31 to 60 minutes ................................ 

##  4 More than 60 minutes ....................... 

##  5Elem entary School Student Questionnaire - Spring 2013 

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## Part 3 **: Ab** **out Your Friends This section asks questions about y** **our friends.** Q 1 7 . How many of your close friends do your parents know by name? **(** **Check one)** ( P revious DC Choice Study survey ) All of them ................................ ........ 

##  1 Most of them ................................ ..... 

##  2 Som e of them ................................ .... 

##  3 None of them ................................ ..... 

##  4 Q 18 . Think about your close friends. How many of them do the following? **(** **Check one box on each row)** ( P revious DC Choice Study survey ) All of them Som e

of them A few of

them None Use bad language regularly ............................... 

##  1 

##  2 

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##  4 Sm oke cigarettes regularly ................................ 

##  1 

##  2 

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##  4 Drink beer or alcohol regularly ........................... 

##  1 

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##  4 Use illegal d rugs regularly ................................ 

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##  4 Tal k about classes in school and what they are learning ................................ ................ 

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##  4 Tal k about what could be done to im prove the neighborhoods and the city ............ 

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##  4 Q19 . Do you agree or disagree with the following statements: **(** **Check one box on each row)** ( Bishop, CAHRS WP03-06 Item 19 ) Agree strongly Agree Disagree Disagree strongly My friends make fun of people who try to do real well in school ................................ ...... 

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##  4 My friends joke around and annoy the teacher ................................ ............................... 

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##  4 To keep up with m y friends, I have to work hard at m y school work ............................. 

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##  4 My friends think kids who study a lot are less popular ................................ ........................ 

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##  4Elem entary School Student Questionnaire - Spring 2013 

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Q20 . How important do your friends think it is to: **(** **Check one box on each row)** ( Bishop, CAHRS WP03-06 Item 23 ) Very im portant Som ewhat

im portant Not too

im portant Not at all

im portant Stud y hard to get good grades ........................... 

##  1 

##  2 

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##  4 Tal k/hang out with friends ................................ 

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##  4 Participate in class ................................ ............. 

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##  4 Q2 1 . Wh ich group of friends do you listen to the most when yo u think about school? **(** **Check one box)** ( new item ) Friends from your neighborhood ................................ .... 

##  1 Friends from school ................................ ........................ 

##  2 My neighborhood friends are the same as my school friends ................................ ...................... 

##  3

**Thank you, please hand in your survey.**