APPENDIX F

STUDENT RECORDS DATA COLLECTION

1. Cover letter

2. Instructions for Providing Student Records
An Affirmative Action/Equal Opportunity Employer

P.O. Box 2393

Princeton, NJ 08543-2393

Telephone (609) 799-3535

Fax (609) 799-0005

www.mathematica-mpr.com

[DATE]

Dear [DISTRICT CONTACT]:

We would like to thank your district for participating in the national Evaluation of the Teacher 

Incentive Fund (TIF) conducted by Mathematica Policy Research for the U.S. Department of 

Education. This study will produce valuable information on the impact of performance-based 

incentive programs on student achievement and educator mobility and retention. We greatly 

appreciate your assistance with this important study. 

As part of the study, we are collecting information from district records for the students in the 

study. I am writing to request that your district provide us with data for each student in tested 

grades in the study schools. We will be making the same data request in fall 2013, 2014, and 2015. 

Please note that cooperation with these activities is a condition of your grant (EDGAR: part 75.591, 

Authority: 20 U.S.C. 1221e–3 and 3474).

The attached table indicates the specific items that we are requesting for the current school 

year. Also attached are instructions for returning the data to us. You can choose among three ways 

to return the data: (1) posting the files to our secure website; (2) emailing the password-protected 

files; or (3) sending the hard copy lists via Federal Express. 

Thank you very much for your assistance with this data request. A member of our study team 

will contact you in the next week to determine if you have any questions about this request. You 

can reach me at (202) 484-4820 or mgrider@mathematica-mpr.com.

Sincerely,

Mary Grider

Senior Systems Analyst

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

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

information collection is estimated to average 8 hours per year minutes per respondent, including the time to review instructions, gather the 

data needed, and complete and review the information collected. If you have any comments concerning the accuracy of the time 

estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 20202. If you have 

comments or concerns regarding the status of your individual submission of this form, write directly to: U.S. Department of Education, 

Institute of Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208.

STUDENT RECORDS DATA REQUEST 
Item # Data Item

Student’s Background and Demographic Information

1 Last and first name 

2 Sex

3 District ID number

4 Date of birth (mm/dd/yy)

5 Ethnicity (Hispanic or Latino origin)

6 Race

Year-Specific Information (2011–2012)

7 School Name

8 School ID

9 Days Enrolled

10 Student’s grade level

11 Free- or reduced-price school lunch status

12 English Language Learner (ELL) status 

13 Special education/IEP status

14 Type of disability, if any

15 504 Plan status

Test Scores (Spring 2012 and Spring 2011)

16 Math test information

Name of test, publisher, grade level administered. If alternative assessment, please 

indicate.

17 Math scale score

Scale score from math section of state or district test. Scale score is preferred, but 

normal curve equivalents, percentile ranks, or number correct are acceptable (in 

descending order of preference).

18 Reading test information

Name of test, publisher, grade level administered. If alternative assessment, 

indicate this.

19 Reading scale score

Scale score from math section of state or district test. Scale score is preferred, but 

normal curve equivalents, percentile ranks, or number correct are acceptable (in 

descending order of preference).

Attendance and Promotion Information (2011-2012)

20 Promotion status

Indicate whether the student was promoted to a higher grade as of May/June prior 

to the start of the school year.

21 Number of days absent from school

22 Disciplinary record

Information on suspensions or other disciplinary action

Teacher Information (2011-2012)

Student’s Reading, Language Arts, or English teacher

23 Last name of teacher

24 First name of teacher

25 District ID of teacher

Student’s Math teacher

26 Last name of teacher

27 First name of teacher

28 District ID of teacher
Notice of Confidentiality

Responses to this data collection will be used only for statistical purposes. The reports prepared for this 

study will summarize findings across the sample and will not associate responses with a specific 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. Additionally, no one at your school or in your district will see your 

responses. Participation or cooperation with this activity is a condition of your grant (EDGAR: part 75.591, 

Authority: 20 U.S.C. 1221e–3 and 3474).
EVALUATION OF THE TEACHER INCENTIVE FUND

INSTRUCTIONS FOR SENDING STUDENT DATA FILES 

Please use one of the three methods below to return the student data files or listing to Mathematica.

A. UPLOAD ELECTRONIC FILES TO A SECURE WEBSITE

1. Go to https://www.xxx.org/upload using an Internet browser (e.g., Microsoft Explorer). When 

prompted, use the following login information:

Username: XXX

Password: XXX 

Domain Name: XXX

Note: Username and password are case-sensitive.

2. Click on the BROWSE button and select the file you wish to transfer.

3. Click the UPLOAD button to begin the transfer process. Once a file is uploaded, it cannot be 

downloaded or accessed by anyone other than an authorized member of the study team.

4. If the file name is not unique, you will receive a message indicating that the “file already 

exists.” If this occurs, please rename your file and upload again.

5. Close the browser once the upload is complete.

6. If your file is password-protected, please call Mary Grider at (202) 484-4820 with the 

password. For security reasons, please do not send the password by email.

B. SEND ELECTRONIC FILE BY EMAIL 

1. If you have not already password-protected your file, please do so and call Mary Grider at 

(202) 484-4820 with the password. For security reasons, please do not send the password by 

email.

2. Email the electronic file as an attachment to data@xxxx.org. In the body of the email, 

include your name, telephone number, and the name of your district. Do not send the student 

data as part of the email text.

3. If possible, compress the file using WinZip, PKZIP, or StuffIt before attaching it to the email. 

If the file is larger than 10 MB (or 10,000 KB), we recommend transmitting it using our secure 

website (https:\\www.xxxx.org) instead.

C. FEDERAL EXPRESS (PAPER LISTS, DISKETTE, CD-ROM, DVD)

1. Use the enclosed prepaid labels and send your package to Mathematica. Please remember to 

write your return address information (Section 1) and the type of packaging you are using 

(Section 5) on the FedEx label.

2. Affix the provided “DO NOT X-RAY; DO NOT BEND” label to the package.

3. If you would like Mathematica to provide a FedEx envelope or other packaging material 

appropriate for the type of student list you are sending, please call Mary Grider at (202) 484-

4820.

4. Keep a copy of the information you send for your records.