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### First Semester 1**2 th** 



### - **Grade Facilitator**  **Survey**

INSTRUCTIONS This survey asks about college and career instruction provided to your students as part of the Roads to Success program . The survey should take about 30 minutes. Your answers are very important to us and will not be shared with anyone at your school or community

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SECTION A: TEACHER BACKGROUND 1. We would like to confirm your sex. Are you male or female? 1 Female 2 Male 2. Are you of Hispanic or [Latino/Latina] origin? 1 Yes 0 No

3. [In addition to learning about your Hispanic background, we would also like to know about your racial background.] Which of the following choices describe your race? You may choose more than one. (Check all that apply.) 1 White 2 Black/African

-American 3 Asian 4 Native Hawaiian or Other Pacific Islander 5 American Indian or Alaska Native 4. What is the highest degree you have earned? 1 Associate’s degree 2 Bachelor’s degree 3 Master’s degree 4 Ph.D., M.D., law degree, or other professional degree 5 You do not have a degree

5. Not including this school year, how many years have you taught a high school grade (9

- 12)? Whole number

6. Not including this school year, how many years have you taught any grade? Whole number

SECTION B: ROADS TO SUCCESS INSTRUCTION In answering the following questions, please focus on instruction provided in the first half of the school year. 7. Which of the following topic areas and modules have you taught to your class so far this year? (Check all that apply) **Topic area** Introduction to Roads to Success

Applying to College

Finding a Job

Financial Aid **Module**

Introduction I Introduction II Completing a College Application Essay Writing I Essay Writing II Essay Writing III Essay Writing IV Work and Values Interest Inventory Who Gets Jobs? Your Network Company Research I Company Research II Your Resume Job Applications Cover Letter I Cover Letter II The Interview Follow

- up Financial Aid Options2 Money Matters

Next Steps Scholarship I

Scholarship II FAFSA I FAFSA II Comparing Aid Packages “Freshman Year” Budget Big Ticket Expenses Health Insurance Budgeting Details Freshman Year Survival Guide Advice from the Experts Getting Ahead at Work 8. For each of the modules you have taught, have you encountered any challenges difficulties in teaching students? If so, what kinds? [List of each module checked in prior question. Teachers to provide a response for each module.] 1 No challenges 2 Lack of materials 3 Lack of student interest 4 Limited instructional time 5 Other (please specify): __________ 9. About how minutes per week have you spent on Roads to Success instruction? Whole number

10. Have you provided Roads to Success instruction each week of the school year so far? [If yes, skip the next two questions] 1 Yes 0 No

11. About how many weeks, if any, have you not been able to provide Roads to Success instruction? Whole number

12. Have you “doubled up” instruction in other weeks to catch up on Roads to Success material? 1 Yes 0 No 13. What obstacles or challenges have prevented you from providing Roads to Success instruction? 1 Lack of preparation time 2 Lack of training on module’s content 3 Competing classroom demands 4 Other (please specify): _____________

14. Have you graded student work produced as part of Roads to Success instruction? 1 Yes, Check/check minus or complete/incomplete 2 Yes, Letter or number grade 3 No 15. Do you plan on providing students a final grade for their Roads to Success participation? 1 Yes, Pass/fail or complete/incomplete 2 Yes, Letter or number grade 3 No 16. Which of the following specific activities, if any, have your students completed as part of your class? 1 Filled out a college application (real or simulated) 2 Completed a Free Application for Federal Student Aid (FAFSA) 3 Prepared a resume 4 Filled out a job application 5 Participated in an internship 6 Participated in an apprenticeship 7 Completed a career interest in ventory SECTION C: OTHER QUESTIONS3

17. Have you taught a specific college and career preparation curriculum before (either Roads to Success or another curriculum)? 1 Yes 0 No

18. Did you receive training in how to teach Roads to Success? If no, skip the next two questions. 1 Yes 2 No

19. How would you rate the amount of training you received to teach Roads to Success? 1 Poor 2 Fair 3 Good 4 Excellent 20. How would you rate the quality of training you received to teach Roads to Success? 1 Poor 2 Fair 3 Good 4 Excellent 21. How would you rate the quality of Roads to Success materials and instruction guides? 1 Poor 2 Fair 3 Good 4 Excellent 22. To what extent have school staff (principal, counselors, or other teachers) supported you in implementing Roads to Success? 1 A great extent 2 Somewhat 3 A little 4 Not at all

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 numb er for this information collection is 1830

- NEW. The time required to complete this information collection is estimated to average 30 minutes per respondent, including the time to review instructions, gather the data needed, and complete and review the info rmation collected. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, p lease 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, Office of Career, Technical, and Adult Education, 400 Maryland Avenue, SW, Washington, DC 20202

- 7100.