HSRS OMB Package

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HIGH SCHOOL REFORM STUDY

Thank you for your school’s participation in this online survey, which is critical to advancing 

important research on high schools. The High School Reform Study (HSRS) seeks to understand 

strategies to help prevent at-risk students from dropping out. An at-risk student is defined as a 

student who is likely to fail at school, specifically failing to achieve basic levels of proficiency in key 

subjects (e.g., math and English) and/or dropping out of school altogether. The study is being 

conducted by SRI International and its partner, RTI International, on behalf of the U.S. Department of 

Education and its High School Graduation Initiative (HSGI). HSGI provides grant funds to states and 

school districts in support of dropout prevention and school reentry efforts.

The survey asks you about policies and strategies at your school during the 2014–15 school year, and 

takes about 30 minutes to complete. Your participation is voluntary. The data collected will be used 

to understand what services and supports are available to high school–age students, what services 

and supports are most prevalent across the country, and the nature of student participation in 

these services and supports. Information collected from school leaders like you will help shape 

efforts to improve the quality of the high school experience, especially for those students at risk for 

not graduating high school.

To begin the survey, please use the Web link provided (_________________). You will be prompted 

to enter the study ID number and password listed below. If you encounter any technical difficulties 

in completing this survey, please contact XXXXXX at RTI International.

Your STUDY ID:

Your STUDY PASSWORD:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a 

collection of information unless such a collection displays a valid OMB control number. The valid 

OMB control number for this information collection is xxxx-xxxx. The time required to complete this 

information collection is estimated to average 30 minutes per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the 

information collection. If you have any comments concerning the accuracy of the time estimate or 

suggestions for improving the interview, please write: U.S. Department of Education, Washington 

D.C. 20202-4651. If you have comments or concerns regarding the status of your individual 

interview, write directly to: High School Reform Study (HSRS), Policy and Program Studies Service, 

Office of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, Washington, DC 

20202.
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Notes to the reviewer:

1) The “prevalence” questions in each section (e.g., “In the 2014-15 school year, does your 

school have case managers?”) are asked of all respondents. Subsequent questions are 

not asked if the respondent does not have the program or service in his/her school.

2) There are directions to the programmer of the online survey about skip logic denoted in 

red text (e.g., If user responds “Yes” to Q1, ask Q2 through Q7).
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1. Which of the following most closely describes your job title?

(Please select only one)

{Only allow one selection}

Principal 

Vice or assistant principal 

School counselor 

Program director or program lead 

Social worker 

Other

(Please specify: ________________________)



2. Including this year, how many years have you been in any 

position or job in this school? 

(Please round up to the next year)

{Only allow one selection}

1 to 5 

6 to 10 

11 to 15 

More than 15 

Background
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3. Which of the following best describes your school? 

(Please select only one)

{Only allow one selection}

A regular school (not including magnet or charter schools). 

A charter school (a school that in accordance with an enabling 

state statute, has been granted a charter exempting it from 

selected state or local rules and regulations).



A special program school or magnet school (e.g., a science or 

math school, performing arts school, talented or gifted school, 

or a foreign language immersion school). 



A career, technical, or vocational school (A high school that uses 

a career-themed curriculum in academic coursework. Designed 

to engage students who are not interested in a traditional 

program of study and to make classes more relevant to them. 

Includes magnet high schools with a career theme such as a 

science, technology, engineering, and mathematics (STEM) high 

school.)



An alternative school (a school that offers a curriculum 

designed to provide nontraditional education to students; e.g., 

to students at risk of school failure or dropout in a traditional 

setting).



4. What type of degree does your school offer? 

(Check all that apply)

High school diploma 

GED or other high school equivalency 

Certificate of attendance 

Other

(Please Specify:__________________) 

None of the above 
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5. In the 2014-15 school year, does your school have case 

managers (sometimes called adult advocates)? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q5, ask Q6 through Q12. Otherwise, skip to Q13.

6. What is the typical caseload for the 

case managers in your school? 

(Please select only one)

{Only allow one selection}

1 to 10 

students

11 to 15 

students

16 to 20 

students

More 

than 20 

students

   

7. How are case managers allocated to students? 

(Please select only one)

{Only allow one selection}

Offered of all students (school-wide) 

Offered to a subset of students 

Assigned to all students (school-wide) 

Assigned to a subset of students 

If user responds “Subset of students,” ask Q8 & Q9. Otherwise, skip to Q10.

8. On average, approximately what 

proportion of students in your school 

receives a case manager in the 2014-15 

school year?

{Slide bar for 1% to 100%}

Case Manager

An adult broker of different services to meet individual 

students’ needs, including academic, social, health, and 

financial (e.g., case management model, intrusive 

advising).
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9. Are any of the following subset(s) of students targeted for receiving a 

case manager?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Reentry students 

English Language Learners 

Other

(Please Specify________________)



10. Typically, which of the following 

qualifications do the case managers in your 

school have?

Required 

to have

Sometimes 

have

Never 

have

Don’t 

know

Licensed in a mental health field (e.g., social 

work)

   

Licensed in a physical health field (e.g., 

nursing)

   

Law degree    

Paralegal degree    

High school counselor    

Certified teacher or certified support staff    

Other

(Please specify: _______________)

   

11. Do the case managers in your school 

provide their services at your school 

location? Always Sometimes Never

Don’t 

know

   
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12. Do the case managers typically fill any 

other roles or duties at your school?

Always Sometimes Never

Don’t 

know

Teaching duties    

Administrative duties    

Social work duties    

School nurse or medical duties    

Guidance counselor    

Mental health counselor or psychologist    
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13. In the 2014-15 school year, does your school have formal adult 

mentor(s)? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q13, ask Q15 through Q22. Otherwise, skip to Q23.

14. How are formal adult mentor(s) allocated to students? 

(Please select only one)

{Only allow one selection}

Offered of all students (school-wide) 

Offered to a subset of students 

Assigned to all students (school-wide) 

Assigned to a subset of students 

If user responds “Subset of students” to Q14, ask Q15 & Q16. Otherwise, skip to Q17.

15. On average, approximately what proportion of 

students in your school receives an adult mentor in 

the 2014-15 school year?

{Slide bar for 1% to 100%}

Adult Mentoring

An adult assigned to student(s) to ensure that they stay 

on track academically, help raise students’ educational 

goals, and offer a sounding board for personal 

concerns. Not a case manager or regular school 

counselor.
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16. Are any of the following subset(s) of students targeted for receiving an 

adult mentor?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Reentry students 

English Language Learners 

Other

(Please Specify________________)



17. Who serves as formal adult mentor(s) in your school?

(Check all that apply)

Teachers 

School counselors 

Administrative staff 

Other school staff 

Community volunteers 

Community-based agency staff 

District-employed staff whose job is to mentor students 

College student 

Other

(Please specify: __________________)


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18. For what purpose do you assign formal adult mentor(s) in your 

school?

(Check all that apply)

To ensure that students stay on track academically 

To provide advice about postsecondary options 

To help raise students’ educational or career goals 

To serve as a sounding board for personal concerns 

To improve student engagement in school 

To prevent at-risk behavior

To model positive and respectful behavior 

To develop conflict resolution skills 

To monitor attendance

To help select classes

To address family issues or concerns 

To explore community resources to address individual needs 

Other

(Please Specify________________)



19. What information do you use to match students with their 

particular adult mentor?

(Check all that apply)

Academic record 

Discipline record 

Teacher recommendation 

Other adult recommendation 

Student selection of mentor 

Convenience (e.g., time, geography) 

Other

(Please Specify________________)



20. Are students required to meet with their formal adult mentor? 

(Please select only one)

{Only allow one selection}

Yes 

No 
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21. On average, how often do students meet with their formal adult 

mentor? 

(Please select only one)

{Only allow one selection}

Daily 

Weekly 

Every other week 

Monthly 

Less than monthly 

I don’t know 

22. On average, how many students share the same formal adult 

mentor? 

(Please select only one)

{Only allow one selection}

1 student 

2 to 5 students 

6 to 10 students 

More than 10 students 
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23. In the 2014-15 school year, did your school make formal 

referrals for any of your students to outside agencies to address 

individual student needs? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q23, ask Q24 through Q28. Otherwise, skip to Q29.

24. To what type of social services does your school most often 

refer students?

(Check all that apply)

Health services 

Mental health services (e.g., anger management, communication, 

fostering healthy relationships, individual and/or family 

counseling)



Child care for teen parents 

Engaging parents/families to understand the academic, career, 

and/or personal needs of the student 

Providing resources to increase parent/family awareness of best 

practices in monitoring academic progress 



Immigrant/new arrivals services 

Addressing material needs (e.g., transportation, shelter, clothing) 

Other

(Please specify: ________________________________)



Access to Social Services

Access to health, mental health, child care, and other 

social services. These services may be provided by the 

school, or schools may refer students and families to 

outside agencies.
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25. To whom do you refer students for social services?

(Check all that apply)

Nonprofit community-based organizations (CBOs) 

Religious/church organization (e.g., Catholic Charities) 

Community mental health agency 

Public health agency 

Juvenile justice agency 

Social services agency 

Local business or other for-profit organization 

Other

(Please specify _____________)



26. On average, approximately what proportion of 

students in your school has been referred to outside 

agencies for social services in the 2014-15 school year?

{Slide bar for 1% to 100%}

27. Are you informed about whether referrals result in action taken 

for the student at the outside agency? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “No” to Q27, ask Q28

28. From your perspective, do referrals typically result 

in action taken by an outside agency? 

(Please select only one)

{Only allow one selection} Yes No

 
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29. Does your school offer any of the following services on-site?

(Check all that apply)

Health services 

Mental health services (e.g., anger management, communication, 

fostering healthy relationships, family counseling) 

Child care for teen parents 

Engaging parents/families to understand the academic, career, 

and/or personal needs of the student 

Providing resources to increase parent/family awareness of best 

practices in monitoring academic progress



Immigrant/new arrivals services 

Addressing material needs (e.g., transportation, shelter, clothing) 

Other

(Please Specify:_____________________)



30. On average, approximately what proportion of 

students receives social services in your school in the

2014-15 school year?

{Slide bar for 1% to 100%}
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31. In the 2014-15 school year, did your school have any formal 

positive school climate programs? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q31, ask Q32 & 33. Otherwise, skip to Q34.

32. In the 2014-15 school year, does your school have any of the 

following positive school climate approaches? 

(Check all that apply)

High expectations for behavior 

Goals for promoting a positive school climate and prosocial 

behavior 

Clear, developmentally appropriate and proportional 

consequences for inappropriate behavior 

Incentives and recognition for successful behavior 

Conflict-resolution strategies and skills 

In-school suspension (to provide oversight and instruction to 

students during their suspension period)



Other

(Please Specify:__________________________)



Positive School Climate Programs

An intentional and structured approach to promoting a positive 

school climate and prosocial behavior. Most approaches include 

clear behavior expectations, incentives and recognition for 

success, and skilled conflict-resolution processes.
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33. Are any of the following subset(s) of students targeted for receiving 

positive school climate approaches?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Reentry students 

English Language Learners 

Other

(Please Specify________________)


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34. In the 2014-15 school year, does your school have credit-recovery 

courses or programs? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q34, ask Q35 through Q42. Otherwise, skip to Q43.

35. Are any of the following subset(s) of students targeted for receiving 

credit-recovery courses or programs?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Re-entry students 

English Language Learners 

Other

(Please Specify________________)



36. On average, approximately what proportion of 

students in your school is offered credit-recovery 

courses or programs in the 2014-15 school year?

{Slide bar for 1% to 100%}

37. How are credit-recovery courses offered?

Please select only one.

{Only allow one selection}

Online 

In person 

Blended learning (e.g., online with an in-person 

facilitator) 

Credit Recovery

Credit-bearing courses to help students make up failed classes 

and keep them on track for graduation.
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38. Where are credit-recovery courses offered?

(Check all that apply)

At your school (including computer or resource lab) 

In the students’ homes

{Load only if “Online” Or “Blended Learning” was selected in Q37}



At another school 

At another location (e.g., reengagement center)

(Please specify: ___________) 

39. When are credit-recovery courses offered to your students?

(Check all that apply)

During the summer 

During the regular school day 

Before and/or after school during the week 

On weekends during the school year (e.g., Saturday school) 

40. Who provides instruction in credit-recovery courses in your school?

(Check all that apply)

Teacher provided by the online course provider

{Load only if the user selects “Online” in Q37} 

Classroom teachers 

Resource lab teachers 

Paid tutors hired by the school 

Unpaid tutors hired by the school 

Tutors hired by an outside organization 

Adult mentors 

Other school staff (e.g., administrators, paraprofessionals) 

Other

(Please specify __________________)



41. On average, approximately what proportion of 

students in your school is participating in credit 

recovery at any location in the 2014-15 school year?

{Slide bar for 1% to 100%}
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42. On average, approximately how many students per teacher are there in each creditrecovery class in your school? 

(Please select only one)

{Only allow one selection}

1 to 5 students 

6 to 10 students 

11 to 15 students 

16 to 20 students 

21 to 25 students 

26 to 30 students 

More than 30 students 
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43. In the 2014-15 school year, does your school have accelerated 

academic programs? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q43, ask Q44 through Q52. Otherwise, skip to Q53.

44. Are accelerated academic programs offered to all students 

(school-wide) or to a specific subset of students? 

Please select only one.

{Only allow one selection}

All students 

(school-wide)

Subset of 

students

 

If user responds “Subset of students” to Q44, ask Q45 & Q46.

45. On Average, approximately what proportion of 

students in your school is offered an accelerated 

academic program in the 2014-15 school year?

{Slide bar for 1% to 100%}

46. Are any of the following subset(s) of students targeted for receiving 

accelerated academic programs?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Re-entry students 

English Language Learners 

Other

(Please Specify________________)



Accelerated Academic Programs

Programs to provide students with the opportunity to experience a 

postsecondary course or earn college credits while in high school 

(e.g., Early/Middle College, Advanced Placement [AP], International 

Baccalaureate [IB], dual enrollment, Cambridge/Advanced 

International Certificate of Education [AICE]).
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47. How are accelerated academic programs delivered to your 

students?

(Please select only one)

{Only allow one selection}

Online 

As a classroom course 

Blended learning (e.g., online with an in-person facilitator) 

48. Where are accelerated academic programs offered?

(Check all that apply)

At your school 

At another high school 

On a college campus 

In the students’ homes

{Load this option only if the user selects “Online” in Q47} 

At another location

(Please specify: ___________) 

49. Who leads or facilitates the accelerated academic programs 

delivered to your students?

(Check all that apply)

A high school teacher, including those certified or hired as a college 

adjunct 

A college professor 

A teacher provided by the online course provider

{Load only if the user selects “Online” in Q47}



Other

(Please Specify________________)



Don’t know 
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50. Are any of the following required for at-risk students to participate 

in these accelerated courses?

(Check all that apply)

Teacher recommendation 

School administrator or guidance/school counselor approval 

Grade level (e.g., only juniors or seniors may enroll) 

Minimum GPA 

Satisfactory attendance record 

Minimum score on a standardized test or college placement exam 

(e.g., state test, SAT or ACT) 

Parent involvement (e.g., parent contract) 

Other

(Please Specify________________)



51. Do you provide any of the following supports to facilitate the 

enrollment and persistence of at-risk students in these courses?

(Check all that apply)

Adult mentors 

Peer mentors 

Credit recovery 

Tutoring 

Academic support classes 

Additional counseling 

Other

(Please Specify________________)


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52. What form of advanced coursework is offered to at-risk students?

(Check all that apply)

Advanced placement (AP) courses for college credit 

International Baccalaureate (IB), an international curriculum 

certified by the International Baccalaureate Organizations 

Early college or middle college program (combining high school and 

college coursework to compress the time it takes to earn both a high 

school diploma and the first two years of college, and/or an 

associate’s degree)



Dual high school and college enrollment classes (students earn both 

high school and college credit) 

Advancement Via Individual Determination (AVID) classes 

Other

(Please Specify________________)


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53. In the 2014-15 school year, does your school offer academic support classes? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q53, ask Q54 through Q60. Otherwise, skip to Q61.

54. How are academic support classes allocated to students? 

Please select only one.

{Only allow one selection}

Offered of all students (school-wide) 

Offered to a subset of students 

Assigned to all students (school-wide) 

Assigned to a subset of students 

If user responds “Subset of students” to Q54, ask Q55 & Q56. Otherwise, skip to Q57. 

55. Are any of the following subset(s) of students targeted for receiving 

academic support classes?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Reentry students 

English Language Learners 

Other

(Please Specify________________)



Academic Support Classes

High school credit-bearing classes designed to support students in 

their required core academic classes, such as algebra, by providing 

additional instructional time (e.g., double-dose instruction). Part of a 

students’ regular schedule of classes; different from academic 

tutoring.
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56. On average, approximately what proportion of 

students in your school is participating in academic 

support classes in the 2014-15 school year?

{Slide bar for 1% to 100%}

57. When are the academic support classes in your school typically 

taught? 

(Please select only one)

{Only allow one selection}

Same day, right before or after the regular core course 

Same day, but not right before or after the regular core course 

A different day in the same semester 

In a different semester 

58. Who typically teaches the academic support classes in your school? 

(Check all that apply)

The student’s regular core course teacher (e.g., English, math, science) 

Another regular core course teacher 

A special education classroom or pull-out teacher (also teaches students 

outside of support classes) 

A teacher who only teaches support courses (does not have any other 

teaching duties) 

A tutor (unlicensed educator) 

Other

(Please specify_________________)



59. What curriculum is used in academic support classes in your school? 

(Please select only one)

{Only allow one selection}

The same curriculum used in the regular core course 

A support curriculum or materials aligned with the regular core course 

A support curriculum or materials not aligned with the regular core 

course



There is no curriculum 

Other

(Please specify_________________)


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60. How are academic support classes delivered? 

(Please select only one)

{Only allow one selection}

Online 

In person 

Blended learning (e.g., online with an in-person facilitator) 
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61. In the 2014-15 school year, does your school have mandated academic tutoring? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q61, ask Q62 through Q70. Otherwise, skip to Q71.

62. Are any of the following subset(s) of students targeted for mandated 

tutoring?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Re-entry students 

English Language Learners 

Other

(Please Specify________________)



63. On average, approximately what proportion of 

students in your school is participating in academic 

tutoring in the 2014-15 school year?

{Slide bar for 1% to 100%}

64. Who provides the academic tutoring in your school?

(Check all that apply)

A teacher licensed in a core academic subject 

A teacher licensed in a noncore subject 

A licensed special education teacher 

A professional tutor 

An unlicensed educator 

Other

(Please specify_________________)



Academic Tutoring

Mandated tutoring for students who have fallen behind academically. 
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65. Who pays the academic tutors in your school?

(Check all that apply)

Tutors are paid by the school/district budget 

Tutors are paid by an outside organization 

Tutors are unpaid 

Other

(Please specify __________________)



66. Do the individuals who provide mandated tutoring in your 

school also teach other classes? 

(Please select only one)

{Only allow one selection}

Tutors do not have other teaching duties in my school 

Tutors also teach core academic subject classes (e.g., 

mathematics, English, science) 

Tutors also teach noncore subject classes (e.g., art, music) 

Tutors also teach special education students 

67. How is tutoring delivered?

(Please select only one)

{Only allow one selection}

Online 

In person 

Blended learning (e.g., online with an in-person facilitator) 

68. Is tutoring offered one-on-one or in groups? 

(Please select only one)

{Only allow one selection}

One-on-one 

In small groups (10 or fewer students) 

In large groups (more than 10 students) 
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69. When is tutoring typically offered to your students? 

(Please select only one)

{Only allow one selection}

Before school 

After school 

During the school day (e.g., lunch, study hall) 

On the weekend 

70. What is the relationship between mandatory tutoring and classroom 

instruction?

(Check all that apply)

Tutors use similar materials as the classroom teacher to provide additional 

instructional time 

Tutors use supplemental materials aligned with the regular core course 

Tutors use supplemental materials NOT aligned with the regular core course 

Tutors answer questions and hold study sessions for upcoming tests 

Tutors provide homework assistance 

Other

(Please specify _____________) 
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71. In the 2014-15 school year, does your school have student support teams? 

(Please select only one)

{Only allow one selection} Yes No

 

If the user responds “Yes” to Q71, ask Q72 through Q77. Otherwise, skip to Q78.

72. Are any of the following subset(s) of students targeted for receiving a 

student support team?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Reentry students 

English Language Learners 

Other

(Please Specify________________)



73. On average, approximately what proportion of 

students in your school has a student support team in 

the 2014-15 school year?

{Slide bar for 1% to 100%}

74. Does your school have more than one student support team? 

Please select only one.

{Only allow one selection} Yes No

 

Student Support Teams

A team of staff to support students who exhibit behavior or 

performance problems—an academic and/or behavioral intervention 

used to provide early, systematic assistance to students who are 

having difficulty in school (may be offered in a multitiered system of 

supports).
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If the user responds “Yes” to Q74, ask Q75 through Q77. Otherwise, skip to Q78.

75. How are your student support teams organized?

(Check all that apply)

By grade level 

Across grades 

By type of student need (e.g., behavior versus academic problem) 

By type of academic or behavioral intervention 

Convenience 

Other

(Please specify: ____________________)



76. Who is included on student support teams?

(Check all that apply)

Regular classroom teachers 

Special education teachers 

Intervention specialists (not a classroom or special education teacher) 

Instructional coaches 

School counselors 

School psychologists 

School administrators 

Social workers 

School nurse 

Other

(Please specify: ____________________)



77. What services do the student support teams provide?

(Check all that apply)

Implement increasing tiers of school-based intervention services 

Develop student intervention plans 

Monitor student progress 

Referrals to intervention services (e.g., reading or math specialist, counseling, 

intensive case management) 

Other

(Please specify: ____________________)


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78. In the 2014-15 school year, does your school have an early warning system? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q78, ask Q79 through Q85. Otherwise, skip to Q87.

79. Is your early warning system used with any of the following grades?

(Check all that apply)

Before 9th grade 

9th grade 

10th grade 

11th grade 

12th grade 

80. Are any of these data collected in your early warning system?

(Check all that apply)

State achievement test scores 

Attendance 

Truancy and/or chronic absenteeism 

Course grades 

Discipline incidents including suspensions or expulsions 

Involvement with criminal justice system 

Involvement with social services or foster care 

Pregnancy/teen parenthood 

Reports of substance abuse 

Homelessness or frequent address change 

Limited English proficiency 

Migrant status 

Students overage for their grade level 

Students who are behind in accumulating credits for their grade level 

Other

(Please specify __________________)



Early Warning System

Systems based on student-level data to detect students who exhibit 

behavior or academic performance issues that put them at risk of 

educational failure.
HSRS OMB Package

33

81. Which of the following data trigger an intervention in your early warning 

system?

(Check all that apply)

{Carry forward only those the user checked in Q80}

State achievement test scores 

Attendance 

Truancy and/or chronic absenteeism 

Course grades 

Discipline incidents including suspensions or expulsions 

Involvement with criminal justice system 

Involvement with social services or foster care 

Pregnancy/teen parenthood 

Substance abuse 

Homelessness or frequent address change 

Limited English proficiency 

Migrant status 

Students overage for their grade level 

Students who are behind in accumulating credits for their grade level 

Other

(Please specify __________________)


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82. What action is taken if a student is flagged by an early warning system?

(Check all that apply)

Meet with teachers and administrators 

Meet with parents 

Develop an intervention plan 

Assign an adult advocate or case manager

{Ask only if the user replied “Yes” to Q5}



Assign an adult mentor

{Ask only if the user replied “Yes” to Q13}



Arrange access to social services 

{Ask only if the user replied “Yes” to Q23}



Mandate positive climate and discipline programs

{Ask only if the user replied “Yes” to Q32}



Assign to credit recovery courses

{Ask only if the user replied “Yes” to Q34}



Assign to double dose or academic support courses

{Ask only if the user replied “Yes” to Q53}



Assign to mandatory tutoring

{Ask only if the user replied “Yes” to Q61}



Refer to student support team

{Ask only if the user replied “Yes” to Q71}



Other

(Please specify __________________)



83. Who has access to the data from early warning systems?

(Check all that apply) 

Students 

Teachers 

School administrators 

District administrators 

Guidance/school counselors 

Adult advocates/case managers

{Ask only if the user replied “Yes” to Q5}



Adult mentors

{Ask only if the user replied “Yes” to Q13}



Student support team

{Ask only if the user replied “Yes” to Q71}



Other

(Please specify __________________)


HSRS OMB Package

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84. Who is primarily responsible for monitoring the early warning systems?

(Please select only one)

{Only allow one selection}

{Carry forward only those the user checked “Yes” on in Q83}

Teachers 

School administrators 

District administrators 

Guidance/school counselors 

Adult advocates/case managers 

Adult mentors 

Student support team 

Other

(Please specify __________________)



85. To what extent do you agree that the data in your early warning systems is: 

Strongly 

agree Agree Disagree

Strongly 

disagree

Routinely accessible to those who need it    

Easily interpreted    

Accurate    

Linked to ongoing intervention tracking and progress 

monitoring    
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36

86. In the 2014-15 school year, does your school have any middle to high school 

transition activities (past or planned)? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q86, ask Q87 through Q90. Otherwise, skip to Q91.

87. In the 2014-15 school year, does your school have any of the following 

middle to high school transition activities (past or planned)?

(Check all that apply)

Summer bridge program for incoming 9th graders (more than a one-day 

orientation)



Freshman academy (students housed together as a smaller unit within the 

high school campus with an assigned group of teachers)



Support team that monitors 9th-grade student progress and provides 

interventions



A student mentor assigned to specific high-risk students 

A student mentor assigned to all incoming 9th-grade students 

An adult mentor assigned to specific high-risk students 

An adult mentor assigned to all incoming 9th-grade students 

A year-long advisory class to provide information and support to succeed in 

high school (e.g., lessons on organizational and study skills or graduation 

requirements) 



Teaching parents strategies to help their child make the transition to high 

school (e.g., graduation requirements, strategies for academic success)



Develop an individual high school graduation plan 

Other

(Please specify ____________________)



Middle to High School Transition

Planned activities to ease the transition from middle to high school, 

such as special outreach and transition programs (e.g., summer 

bridge program, freshman academy)
HSRS OMB Package

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88. How are middle to high school transition activities allocated to 

students entering high school? 

(Please select only one)

{Only allow one selection}

Offered of all students (school-wide) 

Offered to a subset of students 

Assigned to all students (school-wide) 

Assigned to a subset of students 

If user responds “Subset of students” to Q88, ask Q89 & Q90. Otherwise, skip to Q91.

89. On average, approximately what proportion of 

students in your school participates in middle to high 

school transition activities in the 2014-15 school 

year?

{Slide bar for 1% to 100%}

90. Are any of the following subset(s) of students targeted for receiving 

middle to high school transition activities?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Re-entry students 

English Language Learners 

Other

(Please Specify________________)


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91. In the 2014-15 school year, does your school have any flexible scheduling 

alternatives? 

(Please select only one)

{Only allow one selection} Yes No

 

If user selects “Yes” to Q91, ask Q92. Otherwise, skip to Q98.

92. In the 2014-15 school year, does your school have any of the following 

flexible scheduling alternatives?

(Check all that apply)

a. Block scheduling (all classes scheduled for longer class periods or extended 

blocks of instructional time) 

b. Flexible block scheduling (some classes scheduled for longer class periods) 

c. Flexible start and end times (same length of day) 

d. Expanded school day (excluding evening classes) 

e. Shortened school day 

f. Year-round schooling with same number of school days 

g. Additional school days in the year (excluding Saturday classes) 

h. Shortened week (e.g., 4-day week) 

i. Saturday classes 

j. Evening classes 

k. Students working at their own pace using technology / online courses 

l. Other

(Please specify ____________________)



If user checks items i, j, or k in Q92, cycle through Q93 through Q96 for each option.

93. Are {Saturday classes}{Evening classes}{Online courses} 

offered on-site at your school location or off-site? 

(Please select only one)

{Only allow one selection} On-site Off-site

 

Flexible Scheduling

Options that provide flexible and/or extended time for instruction or 

teacher/staff planning such as block scheduling, expanded school day, 

and alternative schedules.
HSRS OMB Package

39

94. How are {Saturday classes}{Evening classes}{Online courses} 

allocated to students? 

(Please select only one)

{Only allow one selection}

Offered of all students (school-wide) 

Offered to a subset of students 

Assigned to all students (school-wide) 

Assigned to a subset of students 

If user responds “Subset of students” to Q94, ask Q95 & Q96. Otherwise, skip to Q98.

95. On average, approximately what proportion of 

students in your school participates in {Saturday 

classes}{Evening classes}{Online courses}?

{Slide bar for 1% to 100%}

96. Are any of the following subset(s) of students targeted for {Saturday 

classes}{Evening classes}{Online courses}?

(Check all that apply)

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Re-entry students 

English Language Learners 

Other

(Please Specify________________)


HSRS OMB Package

40

97. In the 2014-15 school year, does your school have any smaller learning 

communities? 

(Please select only one)

{Only allow one selection} Yes No

 

If user responds “Yes” to Q97, ask Q98. Otherwise, skip to Q99.

98. In the 2014-15 school year, does your school have any of the following types of 

smaller learning communities?

(Check all that apply)

Grade-level academies (e.g., Freshman academy) 

Career-themed academies and pathways 

School-within-a-school (e.g., a co-located smaller school with its own program, 

staff and students) 

Other

(Please specify ____________________)



Smaller Learning Communities

Large comprehensive high school is broken into smaller units with the 

explicit goal of improving teacher-student relationships, ensuring 

teachers know every student, creating a more personal and 

manageable environment for students to navigate.
HSRS OMB Package

41

99. In the 2014-15 school year, how would you describe the coordination of different strategies 

used in your high school?

{Load only the strategies users selected as occurring in their schools}

Frequently 

coordinated

Sometimes 

coordinated

Rarely 

coordinated

Not at all 

coordinated

Case manager {depends on Q5}    

Adult mentoring {depends on Q13}    

Access to social services {depends on 

Q23}

   

Positive school climate programs 

{depends on Q31}    

Credit recovery {depends on Q34}    

Accelerated academic programs {depends 

on Q43}

   

Academic support classes {depends on 

Q53}

   

Academic tutoring {depends on Q61}    

Early warning systems {depends on Q78}    

Student support teams {depends on Q71}    

Middle to high school transition programs 

{depends on Q86}    

Flexible scheduling {depends on Q91}    

Smaller learning communities {depends 

on Q97}    

Coordination of Strategies

School services provided to address the needs of students at risk of 

educational failure may be coordinated with one or more other 

strategies, or they may be isolated. Coordinated services are designed 

to work together in an integrated system to match students to 

appropriate resources. Isolated services operate independently, with 

little communication with other programs or services.
HSRS OMB Package

42

100. For the 2014-15 school year, does your school have any of the following? 

Yes No

a. Instruction in academic readiness skills

Instruction to help students develop behaviors and attitudes that support 

academic performance, including organizational skills, note-taking 

techniques, time management, persistence with difficult tasks, goal 

setting, student collaboration (e.g., skills taught in programs like 

Advancement Via Individual Determination [AVID]).

 

b. Instruction in cognitive strategies

Explicit instruction to develop key cognitive strategies important for 

academic success such as formulating problems, conducting research, 

interpreting conflicting evidence, communicating conclusions and 

findings, completing all work with accuracy.

 

c. Career awareness or exploration activities

Activities designed to build awareness of the variety of careers available 

by exploring career options and to assist students in beginning to identify 

areas of interest with the goal of motivating students and informing their 

decision-making about careers and course selection for such careers.

 

d. Work-based learning

An educational strategy to provide a range of experiences that are 

intentionally designed to help students extend and deepen classroom 

work, such as cooperative education programs, internships, and work 

study in which students earn course credits.

 

e. Advisory systems

A system to provide a structure and set of practices for monitoring and 

supporting students’ academic progress and college and career readiness 

throughout their high school career. The emphasis is on relationships, 

coaching, and facilitation and an agenda driven by student needs rather 

than subject matter content. Not a blanket advisory period for a group of 

students.

 

Additional Strategies: 

To be asked if there is enough time in the survey
HSRS OMB Package

43

Cycle through Q101 and Q102 for each strategy the user selects in Q100.

101. Is {service} offered to all students (school-wide) or to a 

specific subset of students?

All students 

(school-wide)

Subset of 

students

 

If user responds “Subset of students” to Q101, ask Q102

102. Please indicate which subset(s) of students are targeted for receiving 

{service}.

Students with attendance issues (e.g., truancy, suspension, expulsion) 

Students performing below standards or grade level 

Students performing above standards or grade level 

Students in a particular grade level, regardless of performance 

Students recommended by high school staff (e.g., counselor or teacher) 

Re-entry students 

English Language Learners 

Other

(Please Specify________________)


HSRS OMB Package

44

Appendix B: Notification Letters and Fact Sheet 
HSRS OMB Package

45

District Letter #1 (No research application)

[Date]

<SUPERINTENDENT NAME> Web Address: 

<DISTRICT NAME> Your STUDY ID: <XXXXXXX>

<ADDR1> Your PASSWORD: <XXXXXXX>a

<ADDR2>

<CITY STATE ZIP>

Dear <Superintendent>:

We are writing to request your district’s participation in the High School Reform Study (HSRS). One or more schools in 

your district have been selected for this important national study to understand the strategies used by schools to 

prevent dropping out from school and to help students at risk for dropping out. The study is being conducted by SRI 

International and its partner RTI International on behalf of the U.S. Department of Education and its High School 

Graduation Initiative (HSGI). HSGI provides grant funds to states and school districts in support of dropout prevention 

and reentry efforts. 

One school administrator from each sampled school will be asked to complete an online survey during fall 2014. HSRS 

will ask about the policies and strategies at each school and will take approximately 30 minutes for most respondents. 

The survey is designed to be completed by the school principal or a designee who is able to provide information 

about school policies and strategies. 

We are asking you to encourage the school(s) selected in your district to participate in HSRS. Participation is 

voluntary. All responses will be protected from disclosure. No schools or individuals will be identified by name. Data 

collected are used only for statistical purposes and may not be disclosed or used in identifiable form for any other 

purpose except as required by law (Public Law 107-279, Section 183). 

The data collected will be used in analyses to understand what services and supports are available through schools, 

what services and supports are most prevalent across the country, and the nature of participation in these services 

and supports. Information collected from school administrators will help to inform and shape efforts to improve the 

quality of the high school experience, especially for those students at risk for not graduating high school. 

We plan to begin contacting selected schools in about a week. If your district has special research requirements, or if you 

have any questions about the study, please call XXX-XXX-XXXX. If you have questions about your rights as a study participant, 

you may call RTI’s Office for Research Protection in Durham, North Carolina, toll-free at 1-866-214-2043. 

We thank you in advance for your cooperation in this important research.

Sincerely,

Elizabeth Eisner

Office of Planning, Evaluation and 

Policy Development 

U.S. Department of Education

High School Graduation Initiative

U.S. Department of Education 

Office of Elementary and 

Secondary Education

U.S. Department of Education

Enclosure: HSRS Fact Sheet
HSRS OMB Package

46

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such a 

collection displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time 

required to complete this information collection is estimated to average 30 minutes per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have 

any comments concerning the accuracy of the time estimate or suggestions for improving the interview, please write: U.S. Department 

of Education, Washington D.C. 20202-4651. If you have comments or concerns regarding the status of your individual interview, write 

directly to: High School Reform Study (HSRS), Office of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, 

Washington, DC 20202.
HSRS OMB Package

47

District Letter #2 (With Research Application)

[Date]

<SUPERINTENDENT NAME> Web Address: 

<DISTRICT NAME> Your STUDY ID: <XXXXXXX>

<ADDR1> Your PASSWORD: <XXXXXXX>a

<ADDR2>

<CITY STATE ZIP>

Dear <Superintendent>:

We are writing to request your district’s participation in the High School Reform Study (HSRS). One or more schools in 

your district have been selected for this important national study. HSRS seeks to understand the strategies used by 

schools to prevent dropping out from school and to help students at risk for dropping out. The study is being 

conducted by SRI International and its partner RTI International on behalf of the U.S. Department of Education and its 

High School Graduation Initiative (HSGI). HSGI provides grant funds to states and school districts in support of 

dropout prevention and reentry efforts. 

One school administrator from each sampled school will be asked to complete an online survey during fall 2014. HSRS 

will ask about the policies and strategies at each school and will take approximately 30 minutes for most respondents. 

The survey is designed to be completed by the school principal or a designee who is able to provide information 

about school policies and strategies. 

A research application has been sent to your district’s research department. No contact will be made with the 

selected school(s) until we receive approval from the school district.

Participation is voluntary. All responses will be protected from disclosure. No schools or individuals will be identified 

by name. Data collected are used only for statistical purposes and may not be disclosed or used in identifiable form 

for any other purpose except as required by law (Public Law 107-279, Section 183). 

The data collected will be used in analyses to understand what services and supports are available through schools, 

what services and supports are most prevalent across the country, and the nature of participation in these services 

and supports. Information collected from school administrators will help to inform and shape efforts to improve the 

quality of the high school experience, especially for those students at risk for not graduating high school. 

We plan to begin contacting selected schools in about a week. If you have any questions about the study, please call XXXXXX-XXXX. If you have questions about your rights as a study participant, you may call RTI’s Office for Research Protection in 

Durham, North Carolina, toll-free at 1-866-214-2043. 

We thank you in advance for your cooperation in this important research.

Sincerely,

Elizabeth Eisner

Office of Planning, Evaluation and 

Policy Development 

U.S. Department of Education

High School Graduation Initiative

U.S. Department of Education 

Office of Elementary and 

Secondary Education

U.S. Department of Education

Enclosure: HSRS Fact Sheet
HSRS OMB Package

48

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such a 

collection displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time 

required to complete this information collection is estimated to average 30 minutes per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have 

any comments concerning the accuracy of the time estimate or suggestions for improving the interview, please write: U.S. Department 

of Education, Washington D.C. 20202-4651. If you have comments or concerns regarding the status of your individual interview, write 

directly to: High School Reform Study (HSRS), Office of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, 

Washington, DC 20202.
HSRS OMB Package

49

School Initial Contact Letter

[Date]

<SCHOOL ADMIN NAME> Web Address: 

<SCHOOL NAME> Your STUDY ID: <XXXXXXX>

<ADDR1> Your PASSWORD: <XXXXXXX>a

<ADDR2>

<CITY STATE ZIP>

Dear <School Administrator>:

You have been selected to participate in the High School Reform Study (HSRS). Thank you in advance for your school’s 

participation which is crucial to the success of this important research. HSRS seeks to understand the strategies used 

by high schools to help prevent students from dropping out. The study is being conducted by SRI International and its 

partner, RTI International, on behalf of the U.S. Department of Education and its High School Graduation Initiative 

(HSGI). HSGI provides grant funds to states and school districts in support of dropout prevention and reentry efforts. 

We ask you to complete a 30-minute online survey about the policies and strategies at your school. The survey is 

designed to be completed by you or a staff person you designate who can provide information about school policies 

and strategies. Please use the web link, study ID and password provided above to access the survey. 

Your school district has been notified that we are contacting you about the study. All responses will be protected 

from disclosure. No individuals, other than research staff, will see any individually identifying data (for example, 

names or addresses). Data collected are only for statistical purposes and may not be disclosed or used in identifiable 

form for any other purpose except as required by law (Public Law 107-279, Section 183). Participation is voluntary. 

The data collected will be used in analyses to understand what services and supports are available through schools, 

what services and supports are most prevalent across the country, and the nature of participation in these services 

and supports. Information collected from school administrators like you will help to inform and shape efforts to 

improve the quality of the high school experience, especially for those students at risk for not graduating high school. 

If you have any questions about the study, please call XXX-XXX-XXXX. If you have questions about your rights as a study 

participant, you may call RTI’s Office for Research Protection in Durham, North Carolina, toll-free at 1-866-214-2043. 

We thank you in advance for your cooperation in this important research.

Sincerely,

Elizabeth Eisner

Office of Planning, Evaluation and 

Policy Development 

U.S. Department of Education

High School Graduation Initiative

U.S. Department of Education 

Office of Elementary and 

Secondary Education

U.S. Department of Education

Enclosure: HSRS Fact Sheet
HSRS OMB Package

50

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such a 

collection displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time 

required to complete this information collection is estimated to average 30 minutes per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have 

any comments concerning the accuracy of the time estimate or suggestions for improving the interview, please write: U.S. Department 

of Education, Washington D.C. 20202-4651. If you have comments or concerns regarding the status of your individual interview, write 

directly to: High School Reform Study (HSRS), Office of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, 

Washington, DC 20202.
HSRS OMB Package

51

School Reminder Letter #1

[Date]

<SCHOOL ADMIN NAME> Web Address: 

<SCHOOL NAME> Your STUDY ID: <XXXXXXX>

<ADDR1> Your PASSWORD: <XXXXXXX>a

<ADDR2>

<CITY STATE ZIP>

Dear <School Administrator>:

We recently sent you a letter about participation in the High School Reform Study (HSRS). Thank you in advance for your 

school’s participation, which is crucial to the success of this important research. HSRS seeks to understand the strategies used 

by schools to prevent dropping out from school and to help students at risk for dropping out. The study is being conducted 

by SRI International and its partner RTI International on behalf of the U.S. Department of Education and its High School 

Graduation Initiative (HSGI). HSGI provides grant funds to states and school districts in support of dropout prevention and 

reentry efforts. 

Either you or a designee who is able to provide information about school policies and strategies may complete the 30-

minute survey. Please use the Web link, study ID, and password provided above to access the survey at your earliest 

convenience.

Your school district has been notified that we are contacting you about the study. All responses will be protected 

from disclosure. No schools or individuals will be identified by name. Data collected are used only for statistical 

purposes and may not be disclosed or used in identifiable form for any other purpose except as required by law 

(Public Law 107-279, Section 183). Participation is voluntary.

If you have any questions about your participation in the survey, please call XXX-XXX-XXXX. If you have questions about your 

rights as a study participant, you may call RTI’s Office for Research Protection in Durham, North Carolina, toll-free at 1-866-

214-2043. 

We thank you in advance for your cooperation in this important research.

Sincerely,

Elizabeth Eisner

Office of Planning, Evaluation and 

Policy Development 

U.S. Department of Education

High School Graduation Initiative

U.S. Department of Education 

Office of Elementary and 

Secondary Education

U.S. Department of Education

Enclosure: HSRS Fact Sheet
HSRS OMB Package

52

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such a 

collection displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time 

required to complete this information collection is estimated to average 30 minutes per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have 

any comments concerning the accuracy of the time estimate or suggestions for improving the interview, please write: U.S. Department 

of Education, Washington D.C. 20202-4651. If you have comments or concerns regarding the status of your individual interview, write 

directly to: High School Reform Study (HSRS), Office of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, 

Washington, DC 20202.
HSRS OMB Package

53

School Reminder Letter #2

[Date]

<SCHOOL ADMIN NAME> Web Address: 

<SCHOOL NAME> Your STUDY ID: <XXXXXXX>

<ADDR1> Your PASSWORD: <XXXXXXX>a

<ADDR2>

<CITY STATE ZIP>

Dear <School Administrator>:

Your school’s participation in the High School Reform Sstudy is crucial to the success of this important research. 

Please consider completing an online 30-minute survey about the policies and strategies at your school. If you would 

prefer, you may designate someone at your school to complete the survey on your behalf. To access the survey, use 

the Web link, study ID, and password provided above at your earliest convenience.

The data collected will be used in analyses to understand what services and supports are available through schools, what 

services and supports are most prevalent across the country, and the nature of participation in these services and supports. 

Information collected from school administrators will help to inform and shape efforts to improve the quality of the high 

school experience, especially for those students at risk for not graduating high school. 

The study is being conducted by SRI International and its partner RTI International on behalf of the U.S. Department of 

Education and its High School Graduation Initiative (HSGI). HSGI provides grant funds to states and school districts in support 

of dropout prevention and reentry efforts. 

Your school district has been notified that we are contacting you about the study. Participation is voluntary. All responses will 

be protected from disclosure. No schools or individuals will be identified by name. Data collected are used only for statistical 

purposes and may not be disclosed or used in identifiable form for any other purpose except as required by law (Public Law 

107-279, Section 183). 

If you have any questions about your participation in the survey, please call XXX-XXX-XXXX. If you have questions about your 

rights as a study participant, you may call RTI’s Office for Research Protection in Durham, North Carolina, toll-free at 1-866-

214-2043. 

We thank you in advance for your cooperation in this important research.

Sincerely,

Elizabeth Eisner

Office of Planning, Evaluation and 

Policy Development 

U.S. Department of Education

High School Graduation Initiative

U.S. Department of Education 

Office of Elementary and 

Secondary Education

U.S. Department of Education

Enclosure: HSRS Fact Sheet
HSRS OMB Package

54

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such a 

collection displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time 

required to complete this information collection is estimated to average 30 minutes per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have 

any comments concerning the accuracy of the time estimate or suggestions for improving the interview, please write: U.S. Department 

of Education, Washington D.C. 20202-4651. If you have comments or concerns regarding the status of your individual interview, write 

directly to: High School Reform Study (HSRS), Office of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, 

Washington, DC 20202.
HSRS OMB Package

55
HSRS OMB Package

56

Appendix C: Federal Register Notice