APPENDIX F

STUDENT RECORDS DATA COLLECTION

1. Cover letter

2. Instructions for Providing Student RecordsAn 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 n ational Evaluation of the Teache r 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 retent ion. 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 studen t 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 activitie s 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 qu estions 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 inform ation 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, inclu ding 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. Departm ent 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, Washing ton, DC 20208. STUDENT RECORDS DATA REQUESTItem # Data Item Student’s Background and Demographic Information

1 L ast and first name

2 S ex
3 D istrict ID number

4 D ate of birth (mm/dd/yy)

5 E thnicity (Hispanic or Latino origin)

6 R ace
Year

- S pecific Information (201 1

– 201 2 )

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, b ut 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 I D of teacherNotice 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 wit h this activity is a condition of your grant (EDGAR: part 75.591, Authority: 20 U.S.C. 1221e

– 3 and 3474).EVALUATION OF THE TE ACHER 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 FI LES TO A SECURE WEBS ITE

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: U sername 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, p lease 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 a n 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 u sing our secure website ( https: \ \ www.xxxx.org ) instead.

C. FEDERAL EXPRESS (PAP ER 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 l ist you are sending, please call Mary Grider at (202) 484

- 4820

.

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