D-1

Appendix D

Teacher Survey
Teacher Survey 

D-2

OMB#: XXXX-XXXX

Expiration Date: XX/XX/20XX

Implementation of Title I/II Program 

Initiatives

Teacher Survey

Spring 2014

Paperwork Reduction Act of 1995 

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. Public reporting burden for this collection of information is estimated to average 30 

minutes 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. Your response to this collection is voluntary. 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 Ave., SW, Washington, DC 20210-4537 or email ICDocketMgr@ed.gov and 

reference the OMB Control Number XXXX-XXXX. Note: Please do not return the completed survey to this address.

Notice of Confidentiality 

Information collected for this study comes under the confidentiality and data protection requirements of the Institute of Education 

Sciences (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 the study will summarize findings across the sample and will not associate 

responses with a specific district or individual. We will not provide information that identifies you or your district to anyone outside 

the study team, except as required by law.
Teacher Survey 

9/17/2013 D-3

Introduction

The Implementation of Title I/II Program Initiatives study will examine the implementation of policies promoted 

through the Elementary and Secondary Education Act (ESEA) at the state, district, and school levels, in four core 

areas: state content standards, assessments, school accountability, and teacher evaluation. The study will serve 

as an update on implementation of the Title I and Title II provisions since the last national assessment that 

concluded in 2006. The study includes surveys of officials from all state education agencies and district officials, 

school principals, and core academic and special education teachers from nationally representative samples. The 

United States (U.S.) Department of Education, Institute of Education Sciences (IES) is sponsoring this study.

 Your responses are critical to drawing lessons about the implementation of ESEA.

 All survey results will be presented as aggregate findings and no individual schools or teachers will be 

named or otherwise identified in any study reports or other communications that use survey data.

 We will survey a new sample of teachers from your school at a later date so we can examine changes 

occurring in the school over time.

The study, including this survey, is being conducted by Westat and its partners, Mathematica Policy Research 

and edCount. 
Teacher Survey 

9/17/2013 D-4

DEFINITIONS FOR USE THROUGHOUT THIS SURVEY:

Summative assessments are state- or district-mandated tests that are intended to measure students' 

knowledge and skills at (or near) the end of a school year or course relative to grade-level content standards.

Diagnostic assessments are assessments that measure students’ knowledge and skills at interim points during 

the school year to provide timely feedback on their progress toward grade-level content standards so that 

instruction can be adjusted or other support can be provided.

Student achievement growth is the change in student achievement for an individual student between two 

or more points in time, and may be measured using student growth percentiles, value added, or other 

measures of change in student achievement over time. 

Standardized assessments are assessments consistently administered and scored for all students in the 

same grades and subjects, districtwide. These might include required state summative assessments, 

assessments purchased from testing companies, or district-developed assessments that are administered 

districtwide.

WEB PROGRAMMING NOTE: SOME TEXT IN THIS SURVEY WILL BE CUSTOMIZED AS FOLLOWS DEPENDING 

ON WHETHER THE TEACHER IS IN A SCHOOL IN A STATE THAT ADOPTED THE COMMON CORE STATE 

STANDARDS (CCSS) FOR ENGLISH LANGUAGE ARTS (ELA) OR MATH. 

IF THE TEACHER IS IN A SCHOOL IN A STATE THAT ADOPTED THE CCSS IN ELA OR MATH, DISPLAY 

“COMMON CORE STATE STANDARDS (CCSS) FOR ELA OR MATH” OR “CCSS” WHERE NOTED.

IF THE TEACHER IS IN A SCHOOL IN A STATE THAT DID NOT ADOPTED THE CCSS IN ELA OR MATH, DISPLAY 

“CURRENT STATE CONTENT STANDARDS FOR ELA OR MATH” OR “CURRENT STATE CONTENT STANDARDS” 

WHERE NOTED.
Teacher Survey 

9/17/2013 D-5

Section 1. State Content Standards

Many states have recently adopted the Common Core State Standards (CCSS)—that is, content standards for English language arts 

(ELA) and Math that are shared across these states. Other states have substantially revised their own state content standards for 

ELA and Math in recent years. This section includes questions about materials, professional development, and resources you have 

used to revise curriculum and instructional materials to align with the [COMMON CORE STATE STANDARDS (CCSS) FOR ENGLISH 

LANGUAGE ARTS (ELA) OR MATH/ CURRENT STATE CONTENT STANDARDS FOR ENGLISH LANGUAGE ARTS (ELA) OR MATH].

1-1. During this school year (2013-14), is your teaching fully aligned with the [COMMON CORE STATE STANDARDS (CCSS) FOR 

ELA OR MATH/ CURRENT STATE CONTENT STANDARDS FOR ELA OR MATH], partially with the standards, or have you not 

incorporated the standards into your teaching yet?

SELECT ONE RESPONSE IN EACH ROW

FULLY ALIGNED WITH

THE [CCSS/CURRENT 

STATE CONTENT 

STANDARDS]

PARTIALLY ALIGNED 

WITH THE

[CCSS/CURRENT 

STATE CONTENT 

STANDARDS]

NOT ALIGNED WITH

THE [CCSS/CURRENT 

STATE CONTENT 

STANDARDS]

a. English language arts (ELA) .................. 1 2 3

b. Math..................................................... 1 2 3

WEB PROGRAMMING NOTE: DEPARTMENTALIZED MATH TEACHERS WILL 

NOT BE ASKED ABOUT ELA, AND DEPARTMENTALIZED ENGLISH/READING 

TEACHERS WILL NOT BE ASKED ABOUT MATH IN 1-1.
Teacher Survey 

9/17/2013 D-6

1-2. During this school year (2013-14), have you used any of the following materials to revise curriculum to align with the 

[COMMON CORE STATE STANDARDS (CCSS) FOR ELA OR MATH/ CURRENT STATE CONTENT STANDARDS FOR ELA OR 

MATH] and/or plan lessons based on these standards?

(Select NA (not applicable), where available, if you do not teach any English learners or students with disabilities.)

SELECT ONE RESPONSE

IN EACH ROW

YES NO NA

Materials to help align curriculum and instruction with the content standards

a. Documents showing alignment between the previous state standards and the 

[CCSS/ CURRENT STATE CONTENT STANDARDS] ......................................................... 1 0

b. Documents showing alignment between required state summative assessments 

and the [CCSS/ CURRENT STATE CONTENT STANDARDS]............................................ 1 0

c. Tools or guidance on providing instruction aligned with the [CCSS/ CURRENT 

STATE CONTENT STANDARDS] such as scope and sequence, curriculum maps, or 

frameworks.................................................................................................................. 1 0

d. A state-developed model curriculum for ELA or Math instruction for each grade 

or course ...................................................................................................................... 1 0

e. Sample lesson plans consistent with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS] ................................................................................................................ 1 0

f. Examples or videos of instruction consistent with the [CCSS/ CURRENT STATE 

CONTENT STANDARDS]................................................................................................ 1 0

g. Sample student work ................................................................................................... 1 0

h. Sample performance tasks for formative assessment purposes including rubrics 

or scoring guides.......................................................................................................... 1 0

i. Diagnostic assessment tests (or banks of diagnostic assessment items aligned 

with the [CCSS/ CURRENT STATE CONTENT STANDARDS]........................................... 1 0

j. Textbooks or other instructional materials aligned with the [CCSS/ CURRENT 

STATE CONTENT STANDARDS]..................................................................................... 1 0

Materials to facilitate instruction for special populations

k. Documents showing alignment between the [CCSS/ CURRENT STATE CONTENT 

STANDARDS] and the state’s English Language Proficiency standards (standards 

for the progression of English language development for English learners) ............... 1 0 na

l. Materials for understanding how to adapt instruction to help English learners 

meet the [CCSS/ CURRENT STATE CONTENT STANDARDS].......................................... 1 0 na

m. Materials for understanding how to adapt instruction to help students with 

disabilities meet the [CCSS/ CURRENT STATE CONTENT STANDARDS]........................ 1 0 na

Other materials

n. Walk-through or observation protocols to aid in monitoring alignment of your 

instruction to the [CCSS/ CURRENT STATE CONTENT STANDARDS].............................. 1 0

o. Student report cards aligned with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS] ................................................................................................................ 1 0

IF YES IS SELECTED FOR ANY ROW ABOVE, PROCEED TO QUESTION 1-3. 

OTHERWISE, SKIP TO QUESTION 1-4.
Teacher Survey 

9/17/2013 D-7

1-3. Indicate to what extent you found the materials described in the previous question (by category) useful to help revise 

curriculum to align with the [COMMON CORE STATE STANDARDS (CCSS) FOR ELA OR MATH/ CURRENT STATE CONTENT

STANDARDS FOR ELA OR MATH] and/or plan lessons based on these standards.

(Select NA if you did not use that type of material.)

SELECT ONE RESPONSE IN EACH ROW

NOT 

USEFUL 

AT ALL

SOMEWHAT 

USEFUL

MODERATELY 

USEFUL

VERY 

USEFUL NA

a. Materials to help align curriculum and 

instruction with the [CCSS/ CURRENT STATE 

CONTENT STANDARDS] .................................... 0 1 2 3 na

b. Materials to facilitate instruction for special 

populations....................................................... 0 1 2 3 na

1-4. During this school year (2013-14) and including last summer (2013), have you received professional development on any 

of the following topics related to the [COMMON CORE STATE STANDARDS (CCSS) FOR ELA OR MATH/ CURRENT STATE 

CONTENT STANDARDS FOR ELA OR MATH]?

SELECT ONE RESPONSE

IN EACH ROW

YES NO

Professional development topics

a. Information about the [CCSS/ CURRENT STATE CONTENT STANDARDS], such as 

content covered at each grade level and instructional changes or shifts required ... 1 0

b. Instructional strategies consistent with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS], such as model lessons or designing student work .............................. 1 0

c. Adapting instruction to help English learners meet the [CCSS/ CURRENT STATE 

CONTENT STANDARDS].............................................................................................. 1 0

d. Adapting instruction to help students with disabilities meet the [CCSS/ CURRENT 

STATE CONTENT STANDARDS] ................................................................................... 1 0

e. Using student assessment data to improve instruction............................................. 1 0

f. Monitoring alignment of instruction with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS], such as the use of observation protocols............................................ 1 0

IF YES IS SELECTED FOR ANY ROW IN 1-4 PROCEED TO QUESTIONS 1-5, 1-6, AND 1-7. 

OTHERWISE, SKIP TO QUESTION 1-8.
Teacher Survey 

9/17/2013 D-8

1-5. Through which methods did you receive professional development on the topics listed above?

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

Method of delivery of professional development

a. Attended statewide or regional/county conference(s) on these topics.................... 1 0

b. Watched presentation(s) via webinar or video recording(s) on these topics............ 1 0

c. Worked with an instructional coach on these topics.................................................. 1 0

d. Received required in-service professional development on these topics ................. 1 0

e. Worked in teams with other teachers to develop curriculum and lessons aligned 

with the [CCSS/ CURRENT STATE CONTENT STANDARDS]......................................... 1 0

f. Worked with a content area coordinator, a team leader, or a specialist on these 

topics.......................................................................................................................... 1 0

g. Some other mode....................................................................................................... 1 0

1-6. Which one of these methods was the most useful source of professional development related to the [COMMON CORE 

STATE STANDARDS (CCSS) FOR ELA OR MATH/ CURRENT STATE CONTENT STANDARDS FOR ELA OR MATH]?

SELECT ONE ONLY

Attended statewide or regional/county conference(s) on these topics........................... 1

Watched presentation(s) via webinar or video recording(s) on these topics .................. 2

Worked with an instructional coach on these topics....................................................... 3

Received required in-service professional development on these topics........................ 4

Worked in teams with other teachers to develop curriculum and lessons aligned with

the [CCSS/ CURRENT STATE CONTENT STANDARDS] ....................................................... 5

Worked with a content area coordinator, a team leader, or a specialist on these 

topics ................................................................................................................................ 6

Some other mode............................................................................................................. 7

1-7. Indicate to what extent the professional development you received was useful to help plan lessons and use teaching 

strategies aligned with the [COMMON CORE STATE STANDARDS (CCSS) FOR ELA OR MATH/ CURRENT STATE CONTENT

STANDARDS FOR ELA OR MATH]. 

SELECT ONE ONLY

Not useful at all.....................................................................................................................0

Somewhat useful ..................................................................................................................1

Moderately useful ................................................................................................................2

Very useful............................................................................................................................3
Teacher Survey 

9/17/2013 D-9

1-8. During this school year (2013-14), have you participated in any of the following activities related to the [COMMON CORE 

STATE STANDARDS (CCSS) FOR ELA OR MATH/ CURRENT STATE CONTENT STANDARDS FOR ELA OR MATH]? 

SELECT ONE RESPONSE

IN EACH ROW

YES NO

a. Discussed how to implement the [CCSS/ CURRENT STATE CONTENT STANDARDS] at 

faculty, department, or grade-level meetings............................................................... 1 0

b. Worked with other teachers to make connections between the [CCSS/ CURRENT 

STATE CONTENT STANDARDS], curricula, and lesson plans across grades or courses.. 1 0

c. Reviewed the alignment of curriculum and lesson plans to the [CCSS/ CURRENT 

STATE CONTENT STANDARDS] covering the subjects you teach................................... 1 0

d. Dropped material from lesson or unit plans that does not align with the [CCSS/ 

CURRENT STATE CONTENT STANDARDS] ...................................................................... 1 0

e. Set student learning goals or objectives using the [CCSS/ CURRENT STATE CONTENT 

STANDARDS].................................................................................................................. 1 0

f. Developed assignments, projects, tests, or performance tasks aimed at assessing 

student progress toward meeting the [CCSS/ CURRENT STATE CONTENT 

STANDARDS].................................................................................................................. 1 0

g. Provided feedback to students in terms of their progress toward meeting the 

[CCSS/ CURRENT STATE CONTENT STANDARDS]........................................................... 1 0

h. Had central office staff or a school administrator visit your classroom to see how 

your instruction aligns with the [CCSS/ CURRENT STATE CONTENT STANDARDS]........ 1 0

i. Had a coach, mentor teacher, or other instructional leader visit your classroom to 

see how your instruction aligns with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS].................................................................................................................. 1 0

j. Discussed the alignment of your teaching to the [CCSS/ CURRENT STATE 

CONTENT STANDARDS] with school administrators as part of your performance 

evaluation process......................................................................................................... 1 0

k. Had alignment of your teaching with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS] as part of your performance evaluation.................................................. 1 0

l. Include implementing the [CCSS/ CURRENT STATE CONTENT STANDARDS] as part of 

your professional development plan............................................................................. 1 0
Teacher Survey 

9/17/2013 D-10

1-9. During your class instruction this school year (2013-14), how often do you do the following activities? 

(If you teach more than one group of students during the day, please respond for your typical class.)

SELECT ONE RESPONSE IN EACH ROW

NEVER

ONCE 

PER

MONTH 

OR LESS

TWO OR 

THREE 

TIMES PER 

MONTH

ONCE OR 

TWICE 

PER WEEK

THREE OR 

FOUR TIMES 

PER WEEK

EVERY 

DAY

a. Use non-fiction informational 

texts such as historical, 

scientific, or technical narratives 

in your instruction ........................ 0 1 2 3 4 5

b. Use non-fiction literary texts 

such as essays, speeches, 

arguments, art reviews, or 

memoirs in your instruction ......... 0 1 2 3 4 5

c. Require students to include 

evidence from informational or 

literary texts in their writing......... 0 1 2 3 4 5

d. Create assignments that require 

students to use information 

from literary or informational 

texts to complete.......................... 0 1 2 3 4 5

e. In classroom discussions, require 

students to practice using 

evidence from both literary and 

informational texts....................... 0 1 2 3 4 5

f. Provide opportunities for 

students to apply Math concepts 

in real-world situations................. 0 1 2 3 4 5

g. Require students to 

demonstrate conceptual Math 

understanding through complex 

problem solving ............................ 0 1 2 3 4 5
Teacher Survey 

9/17/2013 D-11

1-10. To what extent would you describe the following as challenges to incorporating the [COMMON CORE STATE STANDARDS 

(CCSS) FOR ELA OR MATH/ CURRENT STATE CONTENT STANDARDS FOR ELA OR MATH] into your classroom instruction? 

SELECT ONE RESPONSE IN EACH ROW

NOT A 

CHALLENGE

MINOR 

CHALLENGE

MAJOR 

CHALLENGE

a. Insufficient time for professional development .................... 1 2 3

b. Professional development that is weak or poorly aligned with 

instructional needs................................................................ 1 2 3

c. Insufficient information available about how to revise lessons 

and instructional materials to meet the [CCSS/ CURRENT 

STATE CONTENT STANDARDS] .............................................. 1 2 3

d. Lack of school staff who can mentor or serve as a resource to 

teachers about the [CCSS/ CURRENT STATE CONTENT 

STANDARDS].......................................................................... 1 2 3

e. Lack of guidance or support from the district or school ........ 1 2 3

f. Lack of instructional materials aligned with the [CCSS/ 

CURRENT STATE CONTENT STANDARDS].............................. 1 2 3

g. The additional work required to modify curriculum and lesson 

plans within tight timeframes............................................... 1 2 3

h. Community concerns or opposition to the [CCSS/ CURRENT 

STATE CONTENT STANDARDS] .............................................. 1 2 3

1-11. Overall, to what extent do you view incorporating the [COMMON CORE STATE STANDARDS (CCSS) FOR ELA OR MATH/ 

CURRENT STATE CONTENT STANDARDS FOR ELA OR MATH] into your instruction as a challenge?

SELECT ONE ONLY

Not a challenge.....................................................................................................................1

Minor challenge....................................................................................................................2

Major challenge....................................................................................................................3
Teacher Survey 

9/17/2013 D-12

Section 2. Assessments

In this section of the survey, we will ask about materials or professional development that you have received to help with 

assessment activities, and how you use information from assessments.

2-1. During this school year (2013-14), have you done any of the following to prepare students for required state summative 

assessments in English language arts (ELA) and/or Math? 

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. Strengthened coursework in areas with statewide assessments................................ 1 0

b. Taught test-taking skills to students ............................................................................ 1 0

c. Provided opportunities for students to take practice statewide assessments on 

paper............................................................................................................................ 1 0

d. Provided opportunities for students to take practice statewide assessments online. 1 0

e. Identified students likely to score below state proficiency levels for additional help. 1 0

Next we will ask about the use of a student-level data system. By student-level data system, we mean any technology-based tool 

that provides school leaders and teachers with data that can be used to monitor the achievement of individual students. 

2-2. During this school year (2013-14), do you have electronic access to a student-level data system that includes any of the 

following types of data for students in your classes?

□ Check box if you do not have electronic access to a student-level data system and skip to 2-4

SELECT ONE RESPONSE IN 

EACH ROW

Data System Includes: YES NO

a. Past achievement of each of your current students on required state summative 

assessments................................................................................................................. 1 0

b. Past achievement of each of your current students on districtwide summative 

assessments................................................................................................................. 1 0

c. Achievement of each of your current students on districtwide diagnostic 

assessments................................................................................................................. 1 0

d. Achievement growth of each of your current students on state or districtwide 

summative assessments .............................................................................................. 1 0

e. Past course grades for each of your current students................................................. 1 0

f. Attendance of individual students............................................................................... 1 0

g. Behavior/discipline information for each of your current students............................ 1 0

h. Readiness of each of your current students for grade promotion or graduation 

(“on track” measures).................................................................................................. 1 0
Teacher Survey 

9/17/2013 D-13

2-3. During this school year (2013-14), have you received any of the following related to the data system to help you analyze 

and use student data to inform instruction?

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. Web-based tools........................................................................................................ 1 0

b. Manuals or guidebooks.............................................................................................. 1 0

c. Support from data experts who could address your questions................................. 1 0

2-4. During this school year (2013-14), have you used data on student achievement for any of the following purposes? Data 

on student achievement could come from state summative assessments, districtwide assessments, or assessments you 

developed for your classes.

(Select NA, where available, if you do not teach any English learners or student with disabilities.)

SELECT ONE RESPONSE 

IN EACH ROW

YES NO NA

a. To set measurable learning objectives or goals for your classes...................... 1 0

b. To monitor student progress toward performance targets or learning goals.. 1 0

c. To monitor the progress of English learners .................................................... 1 0 na

d. To monitor the progress of students with disabilities...................................... 1 0 na

e. To identify individual students who are struggling academically..................... 1 0

f. To monitor the progress of students who are struggling academically ........... 1 0

g. To plan whole-class instruction........................................................................ 1 0

h. To plan instruction for individual students....................................................... 1 0

i. To evaluate the effectiveness of a lesson or unit............................................. 1 0

j. To evaluate the effectiveness of your instruction............................................ 1 0
Teacher Survey 

9/17/2013 D-14

2-5. To what extent would you describe the following as challenges to using assessment data to inform your instruction? 

SELECT ONE RESPONSE IN EACH ROW

NOT A 

CHALLENGE

MINOR 

CHALLENGE

MAJOR 

CHALLENGE

a. Limited access to data from prior years on the students I teach 

this year........................................................................................... 1 2 3

b. Timeliness of the data on student achievement from prior years.. 1 2 3

c. Understanding how to analyze information from diagnostic 

assessments to inform instruction.................................................. 1 2 3

d. Getting enough training on analyzing student assessment data to 

inform instruction ........................................................................... 1 2 3

e. Lack of district or school staff who can assist me with questions 

about analyzing student data.......................................................... 1 2 3

f. Having regularly-scheduled time to meet with other teachers as 

a team to discuss student achievement data and instruction ........ 1 2 3

g. Assessments are not well aligned with the curriculum................... 1 2 3

h. Available assessment data do not accurately measure my 

students’ knowledge and skills........................................................ 1 2 3
Teacher Survey 

9/17/2013 D-15

Section 3. School Accountability

3-1. During this school year (2013-14), have school leaders provided any of the following information about your school? 

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. Your school’s performance category, based on your state or district school 

accountability system.................................................................................................. 1 0

b. Why your school is in its current performance category ............................................ 1 0

c. This year’s school goals for student achievement ...................................................... 1 0

d. Strategies your school is pursuing to meet its student achievement goals................ 1 0

e. How you could contribute to meeting student achievement goals for your school... 1 0

f. Strategies to set specific student achievement goals for your classes or students.... 1 0

g. Strategies for you to use in meeting student achievement goals for your classes or 

students....................................................................................................................... 1 0

3-2. During this school year (2013-14) and including last summer (2013), have you participated in any of the following 

activities? 

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. Implemented a new curriculum in your classroom..................................................... 1 0

b. Implemented a comprehensive schoolwide reform model in your classroom........... 1 0

c. Worked a school schedule that provides additional time for student learning 

(relative to a typical schedule for schools in your community) through an extended 

school day, week, or year............................................................................................ 1 0

d. Identified struggling students for school-sponsored individual or small-group 

tutoring outside of the school day .............................................................................. 1 0

e. Provided school-sponsored assistance to struggling students outside of the school 

day at least once a week ............................................................................................. 1 0

f. Participated in a new schoolwide program to increase family and community 

engagement ................................................................................................................ 1 0

g. Participated in a new schoolwide program to address students’ social, emotional, 

or health needs ........................................................................................................... 1 0

h. Implemented a new schoolwide safety or discipline program with your students.... 1 0
Teacher Survey 

9/17/2013 D-16

3-3. To what extent would you describe the following as challenges to improving the achievement of students in your 

classes? 

SELECT ONE RESPONSE IN EACH ROW

NOT A 

CHALLENGE

MINOR 

CHALLENGE

MAJOR 

CHALLENGE

a. Lack of staff who can mentor or serve as a resource to teachers 

about instructional strategies for struggling students ................... 1 2 3

b. Lack of guidance or support from the district or school................. 1 2 3

c. Insufficient classroom resources.................................................... 1 2 3

d. Lack of effective methods/interventions to improve student

achievement................................................................................... 1 2 3

e. Curricula not aligned with the required state summative 

assessments.................................................................................... 1 2 3

f. Teacher concerns or opposition to implementing school 

interventions .................................................................................. 1 2 3

g. Community concerns or opposition to implementing school 

interventions .................................................................................. 1 2 3

h. Lack of parent involvement/participation in children’s 

education....................................................................................... 1 2 3
Teacher Survey 

9/17/2013 D-17

Section 4. Teacher Evaluation

Evaluation

4-1. During this school year (2013-14), is your school participating in a pilot or test of a new teacher evaluation system? 

Yes ........................................................................................................................................1

No .........................................................................................................................................0

DON’T KNOW........................................................................................................................d

4-2. During this school year (2013-14), does your performance evaluation include any of the following sources of information 

on performance? 

SELECT ONE RESPONSE IN EACH ROW

USED IN MY 

EVALUATION

NOT USED IN 

MY 

EVALUATION

DON’T 

KNOW

a. Classroom observations using a teacher professional practice 

rubric, conducted by the principal or other school 

administrator................................................................................ 1 0 d

b. Classroom observations using a teacher professional practice 

rubric, conducted by someone other than a school 

administrator (such as a peer or mentor teacher, instructional 

coach, central office staff member, or an observer from 

outside the school or district) ...................................................... 1 0 d

c. Your self-assessment.................................................................... 1 0 d

d. Portfolios or other artifacts of your teaching practice................. 1 0 d

e. Assessments by a peer or mentor teacher not based on a 

teacher professional practice rubric ............................................ 1 0 d

f. Student work samples.................................................................. 1 0 d

g. Student surveys or other student feedback................................. 1 0 d

h. Parent surveys or other parent feedback .................................... 1 0 d
Teacher Survey 

9/17/2013 D-18

4-3. During this school year (2013-14), will any of the following be evaluated as part of your performance evaluation?

(Select NA, where available, if you do not teach any English learners or students with disabilities.)

SELECT ONE RESPONSE IN EACH ROW

Extent to which you: YES NO

DON’T 

KNOW NA

a. Use assessment data to plan instruction ....................................... 1 0 d

b. Align lessons with the [CCSS/ CURRENT STATE CONTENT 

STANDARDS] in English language arts (ELA) or Math..................... 1 0 d

c. Use instructional strategies aligned with the [CCSS/ CURRENT 

STATE CONTENT STANDARDS] in ELA or Math .............................. 1 0 d

d. Differentiate instruction for English learners................................. 1 0 d na

e. Differentiate instruction for students with disabilities.................. 1 0 d na

f. Collaborate with other school staff................................................ 1 0 d

4-4. So far this school year (2013-14), how many times have you been formally observed by a school administrator, coach, 

mentor or peer for the purpose of evaluating your performance?

(Please consider only instances of formal observations conducted in your classroom. Formal observations are 

standardized using an instrument, rubric or checklist.)

SELECT ONE ONLY

Never ....................................................................................................................................0 Skip to 4-8

Once......................................................................................................................................1

Twice.....................................................................................................................................2

3 times..................................................................................................................................3

4 or more times....................................................................................................................4
Teacher Survey 

9/17/2013 D-19

4-5. Indicate to what extent you agree or disagree with each of the following statements about the formal observations of 

your teaching.

SELECT ONE RESPONSE IN EACH ROW

DISAGREE 

STRONGLY

DISAGREE 

SOMEWHAT

AGREE 

SOMEWHAT

AGREE 

STRONGLY

a. I had a clear sense of what kinds of things the 

observers were looking for when they observed my 

teaching.......................................................................... 1 2 3 4

b. The people who observed my teaching are well 

qualified to evaluate it ................................................... 1 2 3 4

4-6. So far this school year (2013-14), how many times have you received any of the following based on the formal 

observation(s)?

SELECT ONE RESPONSE IN EACH ROW

NEVER ONCE TWICE 3 TIMES

4 OR 

MORE 

TIMES

a. You received oral feedback............................................ 0 1 2 3 4

b. You received written feedback ...................................... 0 1 2 3 4

c. You received specific suggestions or coaching on 

how to improve your teaching....................................... 0 1 2 3 4

d. You received recommendations for resources (e.g., 

professional development, materials, lesson 

examples) to use to improve your teaching................... 0 1 2 3 4

4-7. Indicate to what extent you agree or disagree with each of the following statements about the feedback you received 

based on the formal observation(s) of your teaching.

SELECT ONE RESPONSE IN EACH ROW

DISAGREE 

STRONGLY

DISAGREE 

SOMEWHAT

AGREE 

SOMEWHAT

AGREE 

STRONGLY

a. The feedback was based on the teacher 

professional practice rubric used to assess my 

teaching............................................................................ 1 2 3 4

b. The feedback pointed out specific examples of 

strengths or weaknesses that were observed ................. 1 2 3 4

c. The feedback provided specific ideas about how I 

could improve my instruction .......................................... 1 2 3 4

d. The feedback was a fair assessment of my teaching ....... 1 2 3 4
Teacher Survey 

9/17/2013 D-20

4-8. During this school year (2013-14), will your performance evaluation include measures of student achievement growth on 

standardized student assessments?

(As a reminder, student achievement growth is the change in achievement for an individual student between two or more 

points in time, and may be measured using student growth percentiles, value added, or other measures of change.)

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. Achievement growth on standardized assessments for your own students is 

included in your performance evaluation................................................................... 1 0

b. Achievement growth on standardized assessments for all tested students 

served by your teacher team or grade level is included in your performance 

evaluation ................................................................................................................... 1 0

c. Achievement growth on standardized assessments for tested students 

schoolwide is included in your performance evaluation............................................ 1 0

4-9. During this school year (2013-14), will your performance evaluation include whether your students meet student 

learning objectives or learning goals that you set at the beginning of the school year (perhaps in consultation with your 

principal)?

Yes ........................................................................................................................................1

No .........................................................................................................................................0

DON’T KNOW........................................................................................................................d

4-10. Please indicate to what extent you agree or disagree with each of the following statements about your performance 

evaluation for this school year (2013-14).

(Select NA, where available, if student achievement growth is not used in your performance evaluation.)

SELECT ONE RESPONSE IN EACH ROW

DISAGREE 

STRONGLY

DISAGREE 

SOMEWHAT

AGREE 

SOMEWHAT

AGREE 

STRONGLY NA

a. Student achievement growth for my students is 

a fair way to assess my contribution to student 

achievement ........................................................... 1 2 3 4 na

b. My overall evaluation covers all important 

aspects of my performance as a teacher................ 1 2 3 4

c. In the long run, students will benefit from 

including measures of student achievement 

growth in the evaluations of teachers.................... 1 2 3 4 na
Teacher Survey 

9/17/2013 D-21

4-11. Will your performance evaluation results for this school year (2013-14) be used to inform any of the following decisions? 

SELECT ONE RESPONSE

IN EACH ROW

YES NO

DON’T 

KNOW

Evaluation results will be used to inform decisions about:

a. Feedback provided on your professional practice ................................................... 1 0 d

b. Planning your professional development ................................................................ 1 0 d

c. Developing a performance improvement plan ........................................................ 1 0 d

d. Setting goals for student achievement growth for the next school year................. 1 0 d

e. Determining whether you should receive coaching, mentoring, or peer 

assistance ................................................................................................................. 1 0 d

f. Determining your annual salary increase................................................................. 1 0 d

g. Determining whether you receive a bonus or performance-based compensation 

other than a salary increase..................................................................................... 1 0 d

4-12. Could teacher evaluation results for this school year (2013-14) be used to inform any of the following decisions?

(Select NA, where available, if tenure is not offered in your district or school.)

SELECT ONE RESPONSE IN EACH ROW

Evaluation results could be used to inform decisions about: YES NO

DON’T 

KNOW NA

a. Recognizing highly effective teachers............................................................ 1 0 d

b. Granting tenure or similar job protection...................................................... 1 0 d na

c. Career advancement opportunities, such as teacher leadership roles.......... 1 0 d

d. Determining whether a teacher is eligible to transfer to other schools........ 1 0 d

e. Loss of tenure or similar job protection......................................................... 1 0 d na

f. How potential layoffs in your district could affect teachers.......................... 1 0 d

g. Dismissal or terminating employment for cause ........................................... 1 0 d
Teacher Survey 

9/17/2013 D-22

4-13. During this school year (2013-14) and including last summer (2013), did you receive professional development on any of 

the following topics? 

SELECT ONE RESPONSE

IN EACH ROW

YES NO

DON’T 

KNOW

a. The components of the teacher evaluation system used in your school.................. 1 0 d

b. The teacher professional practice rubric, including specific examples of 

performance at various rating levels for each item in the rubric.............................. 1 0 d

c. Creating student learning objectives and/or measures of student achievement 

growth ....................................................................................................................... 1 0 d

d. How a teacher’s contribution to student achievement growth is defined and 

measured ................................................................................................................... 1 0 d

4-14. During this school year (2013-14) and including last summer (2013), about how many hours of professional development 

on the teacher evaluation system did you participate in? 

(If you did not participate in any professional development on the teacher evaluation system during this period, please 

enter “0” below. Your best estimate is fine.)

_________ HOURS

4-15. During this school year (2013-14), have you received or had access to any of the following materials or events to help you 

understand the system for evaluating your performance?

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. A website or page dedicated to providing information on the evaluation system.... 1 0

b. An information session at your school or in your district.......................................... 1 0

c. A hot line, email address, or web form for questions about the evaluation 

system........................................................................................................................ 1 0

d. Regular reports on the progress of planning or implementing the system............... 1 0

e. A manual or handbook describing how the evaluation system is intended to 

operate....................................................................................................................... 1 0

f. Examples of what different levels of performance as defined by the system 

look like in practice .................................................................................................... 1 0
Teacher Survey 

9/17/2013 D-23

4-16. Please indicate to what extent you agree or disagree with each of the following statements about your understanding of 

the system that will be used to evaluate your performance this school year (2013-14).

SELECT ONE RESPONSE IN EACH ROW

DISAGREE 

STRONGLY

DISAGREE 

SOMEWHAT

AGREE 

SOMEWHAT

AGREE 

STRONGLY

a. I have a good understanding of the procedures 

involved in the evaluation system.................................... 1 2 3 4

b. I have a good understanding of how the 

performance levels are defined ....................................... 1 2 3 4

c. It is clear to me what I need to do to get the 

performance rating I want ............................................... 1 2 3 4

d. Overall, I have a good understanding of the 

evaluation system ............................................................ 1 2 3 4

Professional Development

4-17. During this school year (2013-14), have you had access to professional development that is specifically linked to areas for 

improvement identified either by formal observations of your practice this year or by your performance evaluation last 

school year?

(Select NA if you have not had a formal observation of your practice this year or a completed performance evaluation for 

last school year.)

SELECT ONE RESPONSE

IN EACH ROW

YES NO NA

a. An online resource that identifies professional development opportunities 

linked to my specific areas for improvement.............................................................. 1 0 na

b. The principal or another school leader identifies professional development 

opportunities linked to my specific areas for improvement....................................... 1 0 na

c. A video library that illustrates teaching practices consistent with higher ratings 

on specific items on the teacher professional practice rubric .................................... 1 0 na

d. Self-paced, internet-based professional development modules linked to my 

specific areas for improvement................................................................................... 1 0 na
Teacher Survey 

9/17/2013 D-24

4-18. Thinking now about how decisions about professional development are made, to what extent were you able to choose 

the content or focus of the professional development in which you participated during this school year (2013-14) and 

including last summer (2013)? 

(Select only one response that best describes the amount of choice you had in selecting professional development 

content/focus.)

SELECT ONE ONLY

All professional development content was assigned by others (e.g. school or 

district leaders)................................................................................................................. 1

I was able to choose the content/focus of a small part of the professional 

developing in which I participated ................................................................................... 2

I was able to choose the content/focus of a large part of the professional 

development in which I participated................................................................................ 3

I was able to choose the content/focus of all the professional development in 

which I participated.......................................................................................................... 4

4-19. During this school year (2013-14), does your school have an instructional coach available to help you improve your 

teaching? 

(An instructional coach provides intensive, on-site support to teachers to help them improve instructional practice. For 

this survey, instructional coaches do not include mentors exclusively assigned to help new teachers, or to assist struggling 

teachers placed in a peer assistance program.)

Yes ........................................................................................................................................1

No .........................................................................................................................................0 Skip to 4-21

DON’T KNOW........................................................................................................................d Skip to 4-21
Teacher Survey 

9/17/2013 D-25

4-20. During this school year (2013-14), how many times have you worked one-on-one or in a small group with an instructional 

coach on any of the following topics?

(Select NA, where available, if you do not teach any English learners or students with disabilities.)

SELECT ONE RESPONSE IN EACH ROW

NEVER ONCE TWICE

3-4 

TIMES

5 OR 

MORE 

TIMES NA

a. Implementing the [CCSS/CURRENT STATE 

CONTENT STANDARDS] in ELA or Math ..................... 0 1 2 3 4

b. Adapting instruction to the needs of English 

learners ...................................................................... 0 1 2 3 4 na

c. Adapting instruction to the needs of students with 

disabilities................................................................... 0 1 2 3 4 na

d. Using assessment results to plan instruction............. 0 1 2 3 4

e. Understanding how the state or district measures 

student achievement growth..................................... 0 1 2 3 4

f. Improving your content knowledge ........................... 0 1 2 3 4

g. Improving your classroom management or 

relationships with students........................................ 0 1 2 3 4

4-21. During this school year (2013-14), do you and other teachers have common planning time to meet in teams? 

Yes ........................................................................................................................................1

No .........................................................................................................................................0 Skip to 4-24
Teacher Survey 

9/17/2013 D-26

4-22. How often do you have common planning time with other teachers in your school? 

SELECT ONE ONLY

Daily ......................................................................................................................................1

Several times per week.........................................................................................................2

Once per week......................................................................................................................3

Several times per month ......................................................................................................4

Several times per year..........................................................................................................5

4-23. Does your school require that you participate in common planning time? 

Yes ........................................................................................................................................1

No .........................................................................................................................................0

4-24. During this school year (2013-14), about how often have you engaged in any of the following activities with other 

teachers? 

SELECT ONE RESPONSE IN EACH ROW

NEVER

SEVERAL 

TIMES 

PER 

YEAR

SEVERAL 

TIMES 

PER 

MONTH

ONCE 

PER 

WEEK

SEVERAL 

TIMES 

PER 

WEEK DAILY

a. Received feedback on your teaching 

practice from colleagues ........................... 0 1 2 3 4 5

b. Planned lessons or courses with 

teachers of the same grade or subject...... 0 1 2 3 4 5

c. Developed materials or activities for 

particular classes or lessons with 

teachers of the same grade or subject...... 0 1 2 3 4 5

d. Discussed learning needs of individual 

students with colleagues........................... 0 1 2 3 4 5

e. Discussed student assessment results 

with colleagues.......................................... 0 1 2 3 4 5

f. Exchanged feedback with colleagues 

based on observing in each other’s 

classrooms................................................. 0 1 2 3 4 5

g. Learned from highly effective or highly 

rated teachers in your school or 

district........................................................ 0 1 2 3 4 5
Teacher Survey 

9/17/2013 D-27

School Climate

4-25. Indicate to what extent you agree or disagree with each of the following statements about your school’s climate. 

SELECT ONE RESPONSE IN EACH ROW

DISAGREE 

STRONGLY

DISAGREE 

SOMEWHAT

AGREE 

SOMEWHAT

AGREE 

STRONGLY

a. There is an atmosphere of trust and mutual 

respect at my school ..................................................... 1 2 3 4

b. Teachers at my school support each other in their 

efforts to improve teaching........................................... 1 2 3 4

c. The principal has confidence in the expertise of 

teachers at my school ................................................... 1 2 3 4

d. The method of teacher performance evaluation 

encourages teachers to cooperate rather than 

compete ........................................................................ 1 2 3 4

e. My principal is responsive to teachers’ input ............... 1 2 3 4

f. Teachers can make up for most of the deficits and 

limitations that students bring with them to school..... 1 2 3 4
Teacher Survey 

9/17/2013 D-28

Section 5. Arts Education

5-1. During the 2012-13 school year, how many minutes per week did a typical student in your grade or class spend in arts 

education? 

(Enter the number of minutes. If arts education is offered for part of the year, answer for the weeks the arts classes take

place. Your best estimate is fine.)

__________ MINUTES PER WEEK

It varies by arts education subject (specify)

_____________________________________________________________________

DON’T KNOW.................................................................................................................... d

5-2. During the 2012-13 school year, how often did a typical student in your grade or class receive instruction designated 

specifically as arts education? 

(If arts education is offered for part of the year, answer for the weeks the arts classes take place.)

SELECT ONE ONLY

Every day .......................................................................................................................... 1

3 or 4 times per week ....................................................................................................... 2

Once or twice per week.................................................................................................... 3

Less than once per week .................................................................................................. 4

It varies by arts education subject (specify) ..................................................................... 5

_____________________________________________________________________

Not at all ........................................................................................................................... 0 Skip to 5-4

DON’T KNOW.................................................................................................................... d Skip to 5-4

IF YOU DO NOT TEACH STUDENTS IN ELEMENTARY GRADES, SKIP TO QUESTION 6-1.

IF YOU DID NOT TEACH AT THIS SCHOOL DURING THE 2012-13 SCHOOL YEAR, SKIP TO QUESTION 5-4.

OTHERWISE, PROCEED TO QUESTION 5-1.

DEFINITIONS FOR USE THROUGHOUT THIS SECTION:

Arts Education is defined as visual arts, music, dance, and drama or theatre.
Teacher Survey 

9/17/2013 D-29

5-3. During the 2012-13 school year, for what part of the school year does the arts education class last for a typical student in 

your grade or class (i.e., does a typical student receive arts instruction throughout the full school year or only for some 

portion of the year)? 

(If different types of arts education classes are offered for different parts of the year, add together part-year offerings. If 

one arts class is full-year, select “the entire school year.”)

SELECT ONE ONLY

The entire school year...................................................................................................... 1

Half of the school year...................................................................................................... 2

One-quarter of the school year........................................................................................ 3

Less than one quarter of the school year......................................................................... 4

It varies by arts education subject (specify) ..................................................................... 5

_____________________________________________________________________

DON’T KNOW.................................................................................................................... d

5-4. During this school year (2013-14), how many minutes per week does a typical student in your grade or class spend in arts 

education? 

(Enter the number of minutes. If arts education is offered for part of the year, answer for the weeks the arts classes take

place. Your best estimate is fine.)

__________ MINUTES PER WEEK

It varies by arts education subject (specify)

_____________________________________________________________________

DON’T KNOW.................................................................................................................... d

5-5. During this school year (2013-14), how often does a typical student in your grade or class receive instruction designated 

specifically as arts education? 

(If arts education is offered for part of the year, answer for the weeks the arts classes take place.)

SELECT ONE ONLY

Every day .......................................................................................................................... 1

3 or 4 times per week ....................................................................................................... 2

Once or twice per week.................................................................................................... 3

Less than once per week .................................................................................................. 4

It varies by arts education subject (specify) ..................................................................... 5

______________________________________________________________________

Not at all ........................................................................................................................... 0 Skip to 6-1

DON’T KNOW.................................................................................................................... d Skip to 6-1
Teacher Survey 

9/17/2013 D-30

5-6. During this school year (2013-14), for what part of the school year does the arts education class last for a typical student

in your grade or class (i.e., does a typical student receive arts instruction throughout the full school year or only for some 

portion of the year)?

(If different types of arts education classes are offered for different parts of the year, add together part-year offerings. If 

one arts class is full-year, select “the entire school year.”)

SELECT ONE ONLY

The entire school year...................................................................................................... 1

Half of the school year...................................................................................................... 2

One-quarter of the school year........................................................................................ 3

Less than one quarter of the school year......................................................................... 4

It varies by arts education subject (specify) ..................................................................... 5

______________________________________________________________________

DON’T KNOW.................................................................................................................... d
Teacher Survey 

9/17/2013 D-31

Section 6. Background

6-1. Including the current school year, how many years of teaching experience do you have in each of the following settings?

(Count part of a year as one year; do not give fractions or months.)

YEARS

a. Total number of years teaching ....................................................... ____

b. Total number of years teaching in your current district .................. ____

c. Total number of years teaching in your current school ................... ____

6-2. What is your main role in this school?

SELECT ALL THAT APPLY 

General education classroom teacher..................................................................................1

Special education classroom teacher ...................................................................................2

Resource room teacher ........................................................................................................3

Related serviced provider (e.g., speech therapist)...............................................................4

Program specialist (e.g., full inclusion specialist) .................................................................5

Other (specify)......................................................................................................................6

______________________________________________________________________

6-3. Please indicate which of the following subjects you are teaching during this school year.

SELECT ONE RESPONSE 

IN EACH ROW

YES NO

a. English language arts (ELA) ......................................................................................... 1 0

b. Math............................................................................................................................ 1 0

c. Science ........................................................................................................................ 1 0

d. Social Studies/History ................................................................................................. 1 0

e. English as a second language ...................................................................................... 1 0

f. Other........................................................................................................................... 1 0
Teacher Survey 

9/17/2013 D-32

6-4. Please indicate in what grades you are teaching during this school year. 

SELECT ALL THAT APPLY 

Kindergarten..................................................................................................................... K

First grade......................................................................................................................... 1

Second grade ................................................................................................................... 2

Third grade ....................................................................................................................... 3

Fourth grade ..................................................................................................................... 4

Fifth grade ........................................................................................................................ 5

Sixth grade........................................................................................................................ 6

Seventh grade................................................................................................................... 7

Eighth grade...................................................................................................................... 8

Ninth grade....................................................................................................................... 9

Tenth grade ...................................................................................................................... 10

Eleventh grade.................................................................................................................. 11

Twelfth grade.................................................................................................................... 12

6-5. How would you classify your main teaching assignment at this school, that is, the activity at which you spend most of 

your time during the current school year (2013-14)? 

SELECT ONE ONLY

Full-time teacher working only at this school................................................................... 1

Part-time teacher working only at this school.................................................................. 2

Itinerant teacher (e.g., your assignment requires that you provide instruction at 

more than one school) ..................................................................................................... 3

Long-term substitute (e.g., your assignment requires that you fill the role of a 

regular teacher on a long-term basis, but you are still considered a substitute)............. 4

Other (specify).................................................................................................................. 5

______________________________________________________________________
Teacher Survey 

9/17/2013 D-33

6-6. Of the students you are teaching this school year, what percent are English learners? 

SELECT ONE ONLY

None ................................................................................................................................. 0

1 to 24 percent ................................................................................................................. 1

25 to 49 percent ............................................................................................................... 2

50 to 99 percent ............................................................................................................... 3

100 percent....................................................................................................................... 4

DON’T KNOW.................................................................................................................... d

6-7. Of the students you are teaching this school year, what percent are students with disabilities? 

SELECT ONE ONLY

None ................................................................................................................................. 0 Skip to 6-9

1 to 9 percent ................................................................................................................... 1

10 to 24 percent ............................................................................................................... 2

25 to 39 percent ............................................................................................................... 3

40 to 99 percent ............................................................................................................... 4

100 percent....................................................................................................................... 5

DON’T KNOW.................................................................................................................... d

6-8. Do you teach students with disabilities in a self-contained classroom or an inclusion classroom? 

SELECT ONE ONLY

Self-contained classroom ................................................................................................. 1

Inclusion classroom .......................................................................................................... 2

Both .................................................................................................................................. 3

6-9. What is the highest degree you have earned? 

SELECT ONE ONLY

Do not have a degree ....................................................................................................... 0

Associate’s degree............................................................................................................ 1

Bachelor's degree (B.A., B.S., etc.).................................................................................... 2

Master's degree (M.A., M.A.T., M.Ed., M.S., etc.)............................................................ 3

Educational specialist or professional diploma (at least one year beyond master’s 

level) ................................................................................................................................. 4

Doctorate or first professional degree (Ph.D., Ed.D., M.D., L.L.B., J.D., D.D.S., M.B.A.)... 5
Teacher Survey 

9/17/2013 D-34

6-10. Which of the following describes the teaching certificate you currently hold in this state? 

SELECT ONE ONLY

Regular or standard state certificate or advanced professional certificate ..................... 1

Certificate issued after satisfying all requirements except the completion of a 

probationary period ......................................................................................................... 2

Certificate that requires some additional coursework, student teaching, or 

passage of a test before regular certification can be obtained........................................ 3

Certificate issued to persons who must complete a certification program in order 

to continue teaching......................................................................................................... 4

I do not hold any of the above certifications in this state ................................................ 0

6-11. Are you male or female?

Male.................................................................................................................................. 1

Female .............................................................................................................................. 2

6-12. Are you of Hispanic or Latino origin? 

Yes .................................................................................................................................... 1

No ..................................................................................................................................... 0

6-13. What is your race?

SELECT ALL THAT APPLY

American Indian or Alaska Native..................................................................................... 1

Asian ................................................................................................................................. 2

Black or African American ................................................................................................ 3

Native Hawaiian or Other Pacific Islander........................................................................ 4

White ................................................................................................................................ 5

6-14. Do you speak any language other than English, either in the classroom or outside the classroom, such as at home? 

SELECT ALL THAT APPLY

Yes, Spanish ...................................................................................................................... 1

Yes, some other language................................................................................................. 2

No ..................................................................................................................................... 0

Thank you for completing this survey.