APPENDIX B

PRINCIPAL SURVEY

1. Principal Letter 

2. Principal Questionnaire
PRINCIPAL SURVEY COVER LETTER 

Dear [PRINCIPAL NAME]: 

Your school is participating in the national Evaluation of the Teacher Incentive Fund (TIF) 

conducted by <TBD> for the U.S. Department of Education. This important study will produce 

valuable information on the impact of performance-based incentive programs on student 

achievement, the career paths of principals and teachers, and the ability of schools to retain highquality staff.

As part of the study, school principals are being asked to complete a Web-based survey this spring 

2015. The survey will take about 30 minutes of your time. The survey is designed to learn about the 

hiring practices of school administrators, understand how principals and teachers are evaluated and 

compensated for their performance, and assess principals’ understanding of the TIF program. The 

survey also collects information on principals’ demographic characteristics, educational background, 

and professional experiences. 

While your participation is voluntary, the information collected from principals like you will be 

extremely important to the study’s findings. We will mail you a check for $20 in appreciation of your 

participation upon receipt of the completed questionnaire this year and each subsequent year. 

The information you provide in this survey will be kept strictly confidential and will not be 

shared with anyone outside the study team. District officials, principals, and school staff will 

not have access to the survey data. Responses will be presented only in aggregate form and will 

not identify any individual or school. 

Please use the information below to access the TIF principal survey. 

Go to https://www.xxxxxxx.org/ 

At the login screen, enter the following: 

Login ID: [username] 

Password: [password] 

If you have any questions, please contact xxxxxxx, the deputy survey director, toll free at 866-xxxxxxx or xxxx. 

Thank you for your cooperation and participation in this important study. 

Sincerely, 

xxxxxxxxxxxxx

Survey Director
OMB Control No.: [Program Name]

Expiration Date: 

U.S. DEPARTMENT OF EDUCATION

NATIONAL TEACHER INCENTIVE FUND EVALUATION

PRINCIPAL SURVEY 

SPRING 2015

This survey is part of the evaluation of the Teacher Incentive Fund (TIF), a federally funded initiative on 

performance pay for educators. The survey includes questions about your background, your school’s 

hiring practices, classroom assignments, and knowledge and perceptions of the TIF funded program. 

Please return the completed form to: If you have questions, please contact:

This survey is authorized by law: The ARRA, Division A, Title VIII, Pub. L. 111–5 and Departments of 

Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2010, 

Division D, Title III, Pub. L. 111–117.

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 1850-0876. 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 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.
TIF Spring 2015 Principal Survey

This survey is part of the national evaluation of the Teacher Incentive Fund (TIF), a federally funded 

initiative that will provide valuable information on the potential impact of performance-based incentive 

programs on student achievement and educator mobility. The survey includes questions about your 

background, your school’s hiring practices, classroom assignments, and knowledge and perceptions of 

the TIF funded program.

We would like you to know that:

 This survey is voluntary, but your response is critical for producing valid and reliable data about 

your district’s TIF funded program. You may skip any questions you do not wish to answer; 

however, we hope that you answer as many questions as you can.

 The survey takes about 30 minutes to complete, and once you have completed it, we will send 

you $20 to compensate you for your time.

 Refusal to participate in the principal survey will not affect your employment, or relationship with 

your school or the evaluation partners, including the U.S. Department of Education, in any way.

 The study will provide important information that can be used by principals and other educators. 

Specifically, we will learn whether incentive programs may have a positive impact on student 

achievement and teacher and principal retention. 

 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 school or individual. We will not provide information that identifies you or your school to 

anyone outside the study team, except as required by law. Additionally, no one in your school or 

district will see your responses. 

 Participation in the principal survey does not impose any special risks to you as a respondent 

other than accidental disclosure of information. Safeguards are in place to ensure individual 

respondent’s confidentiality including restricted access to questionnaire data and separating 

identifying information such as name and school from survey responses. All contractor staff sign 

a confidentiality pledge and all staff with access to study data have received clearance from the 

U.S. Department of Education and are subject to severe legal consequences for any breach of 

confidentiality.

 An IRB has reviewed and approved this study. If you have any questions about your rights as a 

research participant, you can contact IRB at 1-800-xxx-xxxx.

I have read and I understand the above statements and agree to participate in the survey.

 
A1. What position do you currently hold at this school?

MARK ONE ONLY

1 Principal

2 Assistant or vice principal

3  Other (Specify): __________________________________________________________

A2. How long have you served in your current position at this school?

MARK ONE ONLY

1  Less than one year.

In what month did you begin serving in your current position? _______________

2  One year or more. 

How many years have you served in your current position? | | | year(s)

A3. Including this school year, how many years have you served in any administrative 

position in this school?

| | | YEARS

A4. Including this school year, how many years have you served in any administrative 

position in any school? 

Include all schools in this or any other district.

| | | YEARS

A. PERSONAL AND PROFESSIONAL BACKGROUND
A5. How satisfied are you with each of the following aspects of your school this year? 

MARK ONE BOX IN EACH ROW

VERY 

DISSATISFIED

SOMEWHAT 

DISSATISFIED

SOMEWHAT 

SATISFIED

VERY 

SATISFIED

a. Opportunities for professional 

advancement................................................................

1  2  3  4 

b. Opportunities to enhance my skills ................................ 1  2  3  4 

c. Opportunities to earn extra pay................................ 1  2  3  4 

d. Use of observations to assess my skills................................ 1  2  3  4 

e. Use of student achievement scores to 

assess my effectiveness ............................................................ 1  2  3  4 

f. Feedback on my performance ................................ 1  2  3  4 

g. Recognition of accomplishments ................................1  2  3  4 

h. Quality of interaction with colleagues................................ 1  2  3  4 

i. Efforts of my colleagues ............................................................. 1  2  3  4 

j. Morale in the school ................................................................ 1  2  3  4 

k. Overall job satisfaction ............................................................... 1  2  3  4 

A6. What is the highest level of education you have completed?

MARK ONE ONLY

1 Bachelor’s degree

2  Master’s degree

3 Doctoral degree (Ph. D., Ed. D.)

4  Other (Specify): ___________________________________________________________

A7. What is your year of birth?

| 1 | 9 | | |
A8. Are you of Hispanic or Latino origin? 

1  Yes

0 No

A9. What is your race?

SELECT ALL THAT APPLY

1  White

2  Black or African American

3  Asian

4  Native Hawaiian or other Pacific Islander

5  American Indian or Alaska Native

A10. Are you male or female?

MARK ONE ONLY

1  Male

2  Female
B1. Which of the following statements best describes the principal’s role in hiring teachers 

for this school?

MARK ONE ONLY

1  Principal has complete autonomy over teacher hiring

2  Principal is part of a school-level team responsible for teacher hiring

3  Principal receives a set of prescreened candidates from the district office as the pool 

from which he or she (or a school team) can interview and hire teachers

4 Principal has little or no input in hiring teachers at this school

5 Other (Specify) __________________________________________________________

B2. In filling teacher vacancies for the 2014-2015 school year, when did your school FIRST 

begin interviewing potential teachers?

MARK ONE ONLY

1

  December 2013 or earlier

2

  January 2014

3

  February 2014

 4

  March 2014

5

  April 2014

 6

  May 2014

7

  June 2014

8

  July 2014

9

  August 2014

10  September 2014 or later

 d

  Don’t know

11  No vacancies to fill GO TO QUESTION B5

B3. During which period did your school conduct the MOST interviews with potential 

hires? 

Write the number or letter from the list in B2 above (1 through 10 or d) that corresponds to that 

period.

| | |
B4. Please provide the information requested below about teaching positions for the 2012-

2013 school year, including activities before the start of the school year.

NUMBER

a. Total number of classroom teacher vacancies ...............................| | |

b. Number of applications your school reviewed for the position(s)...| | |

c. Number of applicants your school interviewed ...............................| | |

d. Number of offers your school made ...............................................| | |

e. Number of offers that were accepted .............................................| | |

B5. How frequently were the following factors about your school used as incentives or 

benefits when recruiting or interviewing teachers for your school? 

MARK ONE BOX IN EACH ROW

NEVER RARELY

SOMETIME

S OFTEN ALWAYS

a. Salary ............................................................ 1  2  3  4  5 

b. Opportunities to earn performancebased pay......................................................

1  2  3  4  5 

c. Opportunities for career advancement.......... 1  2  3  4  5 

d. Opportunities for professional 

development..................................................

1  2  3  4  5 

e. The level of teacher involvement in 

school decision making................................

1  2  3  4  5 

f. Collegiality of teaching staff .......................... 1  2  3  4  5 

g. The school culture and/or educational 

philosophy .....................................................

1  2  3  4  5 

h. The school’s reputation................................ 1  2  3  4  5 

i. The school’s location or neighborhood ......... 1  2  3  4  5 

j. The level of student achievement at the 

school............................................................

1  2  3  4  5 

k. The [Program Name]................................ 1  2  3  4  5 

l. Other factor 1 (Specify)................................ 1  2  3  4  5 

__________________________________

m. Other factor 2 (Specify)................................ 1  2  3  4  5 

__________________________________
B6. Of the factors in Question B5, please indicate, in order of importance, the THREE that 

you feel are the most compelling reasons for teachers to accept a position at your 

school.

a. Most important factor .......| |

b. Second most important ....| |

c. Third most important .......| |

B7. Of the applicants who DID NOT ACCEPT the offer of a teaching position, do you think 

any of the factors listed in Question B5 contributed to that decision?

1  Yes. If yes, in the space below, use the list in Question B5 (a-m) above to write those that apply, or 

write any other factor(s) not on the list.

a. Factor one.................................... | |

b. Factor two .................................... | |

c. Factor three.................................. | |

d. ________________________ Other (Specify)

0

  No factors apply; personal circumstances unrelated to school or position

d

  Don’t know

n

  Not applicable

B8. How frequently did your school use the following criteria when assigning teachers to 

grade levels or subject areas? 

MARK ONE BOX IN EACH ROW

NEVER RARELY SOMETIMES OFTEN ALWAYS

a. The teacher’s experience in a grade level 

or subject area ............................................

1  2  3  4  5 

b. The teacher’s seniority ................................

1  2  3  4  5 

c. The teacher’s content knowledge ...............

1  2  3  4  5 

d. The teacher’s ability to produce high test 

scores in grades/classes in which state or 

federal assessments are administered .......

1  2  3  4  5 

e. The teacher’s ability to work with certain 

student populations (e.g., ESL, special 

needs) .........................................................

1  2  3  4  5 

f. To balance teacher experience and 

expertise in a grade level or subject ...........

1  2  3  4  5 

g. Other (Specify)............................................

1  2  3  4  5 

__________________________________
B9. From the list of criteria in Question B8 above (a-g), please list the top three criteria 

your school uses when assigning teachers to tested grade levels or subject areas

(grades/subject areas annually assessed by district and/or state achievement testing).

a. Criterion one..................................... | |

b. Criterion two ..................................... | |

c. Criterion three................................... | |
For questions in this section, please think about all policies and programs in effect at your school, 

and not just the [Program Name]. NOTE: For questions C1 to C5, please consider only 

instances of formal observations conducted in a classroom. Formal observations are standardized 

by using a rubric or checklist and are usually given at regular intervals. (Informal observations do not 

use a standardized rubric or checklist and are not conducted on any set schedule.)

C1. Are formal classroom observations being conducted or planned to evaluate teacher 

performance in your school?

1 Yes

0  No GO TO QUESTION C6

C2. For each type of school staff listed below, mark Yes or No to indicate if someone in 

that position conducts formal classroom observations to evaluate teacher 

performance this year. 

If a listed position is not relevant to your school, mark ’not applicable’.

MARK ONE BOX IN EACH 

ROW

YES NO

NOT 

APPLICABLE

a. Principal.....................................................................................................

1  0  9 

b. Other administrator (e.g., assistant or vice principal, department 

head) .........................................................................................................

1  0  9 

c. Mentor, master, or lead teacher at your school ........................................

1  0  9 

d. Mentor, master, or lead teacher from a different school ...........................

1  0  9 

e. Content specialist......................................................................................

1  0  9 

f. Other (Specify)..........................................................................................

1  0  9 

_________________________________________________________

C3. How often are formal observations conducted for classroom teachers during the 

school year?

A classroom teacher is typically observed | | | TIMES DURING THE SCHOOL YEAR.

C4. Do teachers have the opportunity to review the instrument or rubric so that they can 

be informed about the criteria on which they are being assessed?

1  Yes

0  No

C5. Is each teacher shown his or her ratings after the classroom observation?

1  Yes

0  No

C. TEACHER EVALUATION AND COMPENSATION AT YOUR SCHOOL
C6. For which of the following roles or activities can teachers at your school earn 

additional pay this school year? 

For each Yes answer, indicate in Column B the maximum amount that a teacher could receive. 

Roles and Responsibilities

A. CAN EARN ADDITIONAL 

PAY?

B. MAXIMUM AMOUNT 

POSSIBLE

a. Mentor teacher ...............................................

1  Yes

0  No

$ | | |,| | | |

b. Master or lead teacher................................

1  Yes

0  No

$ | | |,| | | |

c. Department chair or head...............................

1  Yes

0  No

$ | | |,| | | |

d. Lead curriculum specialist .............................

1  Yes

0  No

$ | | |,| | | |

e. Serving on a school-wide 

committee or task force ................................

1  Yes

0  No

$ | | |,| | | |

f. Serving on a leadership team in 

some capacity (Specify) ................................

________________________________

1  Yes

0  No

$ | | |,| | | |

Other Activities

g. Teaching in a hard-to-staff school 

(e.g., schools serving large 

proportions of economically 

disadvantaged or low-performing 

students).........................................................

1  Yes

0  No

$ | | |,| | | |

h. Teaching high-need subjects (e.g., 

math, science, or special education)..............

1  Yes

0  No

$ | | |,| | | |

i. Attending professional development 

activities or enrolling in graduatelevel courses (exclude tuition)........................

________________________________

1  Yes

0  No

$ | | |,| | | |

i. An automatic bonus (e.g. 1% of 

salary) for participating in [Program 

Name].............................................................

1  Yes

0  No

$ | | |,| | | |
The next series of questions focuses on criteria used to measure the performance of teachers (in 

tested grades and subjects) at your school and to determine performance-based bonuses. 

Performance-based bonuses refer to bonuses based on measured effectiveness and do not include 

additional pay for roles/responsibilities and activities (such as those listed in Question C6).

C7. Is it possible for teachers in tested grades and subjects at your school to earn a bonus 

based solely on their performance for the 2014-2015 school year?

1  Yes  GO TO C8

0  No  GO TO C9

C8. What is the maximum possible performance-based bonus amount that a teacher in a 

tested grade and subject at your school can earn this school year? (If you are not sure, 

please provide your best estimate.) 

Round to the nearest $100.

$ | | |, | | | |
C9. Which of the following performance criteria are used to evaluate teachers in tested grades 

and subjects at your school or to determine their performance-based bonus? 

In column A, indicate whether the performance criterion is used to evaluate teachers’ performance 

at your school.

In column B, indicate whether the performance criterion helps determine whether teachers at your 

school may receive a performance-based bonus or the amount of the bonus they may receive. If it 

is not possible for teachers at your school to earn performance-based bonuses, please mark “N/A” 

for not applicable.

FOR EACH CRITERION, MARK ONE BOX IN 

COLUMN A AND ONE BOX IN COLUMN B

A. IS CRITERION USED 

TO EVALUATE 

TEACHERS’

PERFORMANCE?

B. DOES CRITERION 

AFFECT TEACHERS’

PERFORMANCE-BASED 

BONUSES?

STUDENT ACHIEVEMENT YES NO YES NO N/A

a. Student test scores at a point in time (e.g., 

average scores, proficiency rates, or Adequate 

Yearly Progress – AYP based on 2014-2015 

scores only) ................................................................

1  0  1  0  9

b. Growth in student test scores between the current 

and prior school year(s) at the school level (e.g., 

value-added, average gains) ........................................

1  0  1  0  9

c. Growth in student test scores between the current 

and prior school year(s) in certain student groups

(e.g., grade level, team, subject area) ..........................

1  0  1  0  9

d. Growth in student test scores between the current 

and prior school year(s) in teachers’ individual 

classes ..........................................................................

1  0  1  0  9

DIRECT OBSERVATION

e. Classroom observations................................................ 1  0  1  0  9

f. Professional judgment of principal or other 

administrator, other than classroom observations ........

1  0  1  0  9

ATTENDANCE

g. Teacher attendance ...................................................... 1  0  1  0  9

h. Student attendance....................................................... 1  0  1  0  9

STAKEHOLDER INPUT

i. Reviews from other teachers ........................................ 1  0  1  0  9

j. Parent input................................................................ 1  0  1  0  9

k. Student input ................................................................ 1  0  1  0  9

l. OTHER (Specify) ............................................................. 1  0  1  0  9
C10. Are teachers at your school eligible for non-monetary benefits in recognition of their 

performance or added responsibilities? 

1  Yes

0 No GO TO SECTION D

C11. Which of the following non-monetary benefits are available to teachers at your school? 

MARK ONE BOX IN EACH ROW

YES NO

a. Release from classroom teaching for mentoring or other leadership 

activities................................................................................................... 1  0 

b. Decision making authority on issues such as hiring staff or adopting 

curriculum................................................................................................ 1  0 

c. Priority in teaching assignments (e.g., grade level or subject area) ....... 1  0 

d. Priority in student assignment ................................................................. 1  0 

e. Other (Specify) ........................................................................................ 1  0 

______________________________________________________________

C12. How much do you agree or disagree with each of the following statements?

MARK ONE BOX IN EACH ROW

STRONGLY 

DISAGREE

DISAGREE AGREE 

STRONGLY 

AGREE 

a. The district’s teacher performance 

measures are an accurate measure of 

individual teacher 

performance...............................................

...... 

1  2  3  4 

b. I use the district’s performance measures 

to inform decisions about staffing and 

providing additional support to teachers 

(e.g., staff assignments and professional 

development 

needs)...............................................

.... 

1  2  3  4 
NOTE: For the questions in this section, please think about all policies and programs in effect at your 

school, and not just the [Program Name].

D1. Have you been (or expect to be) observed by a trained observer this year?

1 Yes GO TO D2

0  No GO TO D3

D2. How many times during this school year have you been (or expect to be) observed by 

a trained observer to evaluate your performance? 

| | | OBSERVATION(S) THIS SCHOOL YEAR TO DATE

| | | MORE OBSERVATION(S) EXPECTED BY THE END OF THE SCHOOL YEAR

D3. For which of the following roles or activities can you earn additional pay this school 

year? 

For each Yes answer, indicate in Column B the maximum amount that you could receive, and in 

Column C, the amount you expect to receive.

Roles and Responsibilities

A. CAN EARN

ADDITIONAL 

PAY?

B. MAXIMUM AMOUNT 

POSSIBLE

C. AMOUNT YOU EXPECT 

TO RECEIVE

a. Additional roles or responsibilities in 

the school or district................................

1  Yes

0  No

$ | | |,| | | | $ | | |,| | | |

Other Activities

b. Working in a hard-to-staff school 

(e.g., schools serving large 

proportions of economically

disadvantaged or low-performing 

students).........................................................

1  Yes

0  No

$ | | |,| | | | $ | | |,| | | |

c. Attending professional development 

activities or enrolling in graduate

level courses (exclude tuition)........................

1  Yes

0  No

$ | | |,| | | | $ | | |,| | | |

d. An automatic bonus (e.g. 1% of 

salary) for participating in [Program 

Name].............................................................

________________________________

1  Yes

0  No

$ | | |,| | | | $ | | |,| | | |

D. ADMINISTRATOR EVALUATION AND COMPENSATION AT YOUR SCHOOL
The next series of questions focuses on criteria used to measure your performance and to determine 

performance-based bonuses. Performance-based bonuses refer to bonuses based on measured 

effectiveness and do not include additional pay for roles/responsibilities and activities (such as those 

listed in Question D3).

D4. Is it possible for you to earn a bonus based solely on your performance for the 2014-

2015 school year?

1  Yes GO TO D5

0  No GO TO D7

D5. What do you think is the maximum performance-based bonus that someone in your 

position could possibly earn for this school year? 

Round to the nearest $100.

$ | | | , | | | |

D6. What is your best estimate of the actual amount of performance-based bonus that you 

will receive? 

Round to the nearest $100.

$ | | | , | | | |

D7. Did you receive a bonus based solely on your performance last year? 

1  Yes

0  No
D8. How much do you agree or disagree with the following statements about the 

performance-based bonuses that were distributed based on measured performance 

last year?

MARK ONE BOX IN EACH ROW

STRONGLY 

DISAGREE

DISAGREE AGREE 

STRONGLY 

AGREE 

a. It was explained why I did (or did not) 

receive a performance-based 

bonus.......................

1  2  3  4 

b. I understand how the amounts of the 

performance-based bonuses were 

determined .......................................................

1  2  3  4 

c. I received information about the 

performance-based bonus in a timely 

manner...................... 

1  2  3  4 

d. I feel the performance-based bonus 

payouts were fair..............................................

1  2  3  4 

e. I understand how I can adjust my 

practices this year to try to earn a bonus 

or larger bonus ..................................

1  2  3  4 
D9. Which of the following performance criteria are used to evaluate your performance or to 

determine your performance-based bonus? 

In column A, indicate whether the performance criterion is used to evaluate your performance.

In column B, indicate whether the performance criterion helps determine whether you may receive 

a performance-based bonus or the amount of the bonus you may receive. If you are not eligible for 

a performance-based bonus, please mark “N/A” for not applicable.

FOR EACH CRITERION, MARK ONE BOX IN 

COLUMN A AND ONE BOX IN COLUMN B

A. IS CRITERION 

USED TO 

EVALUATE YOUR 

PERFORMANCE?

B. DOES CRITERION 

AFFECT YOUR 

PERFORMANCE-BASED 

BONUS?

STUDENT ACHIEVEMENT YES NO YES NO N/A

a. Student test scores at a point in time (e.g., 

average scores, proficiency rates, or Adequate 

Yearly Progress – AYP based on 2014-2015 

scores only) ................................................................

1  0  1  0  9

b. Growth in student test scores between the 

current and prior school year(s) at the school 

level (e.g., value-added, average gains).......................

1  0  1  0  9

c. Growth in student test scores between the 

current and prior school year(s) in certain 

student groups (e.g., grade level, team, subject 

area)..............................................................................

1  0  1  0  9

DIRECT OBSERVATION

d. Observations by trained observers ............................... 1  0  1  0  9

INPUT FROM STAKEHOLDERS

e. Teacher assessments................................................... 1  0  1 0  9

f. Parent input................................................................1  0  1  0  9

OTHER MEASURES

g. Other measure 1 (Specify) ........................................... 1  0  1  0  9 

h. Other measure 2 (Specify) ........................................... 1  0  1  0  9 
D10. What is your academic-year base administrative salary for the current school year? 

Do not include the value of potential performance-based bonuses. Please report your beforetax earnings from July 1, 2014 to June 30, 2015.

Round to the nearest $100.

$ | | | | , | | 0 | 0 |

D11. Does your base administrative salary include additional pay for any roles or activities 

you may have performed this year?

1  Yes GO TO D10

0  No GO TO Section E

D12. Please indicate the amount of your base administrative salary that is due to additional 

pay for performing roles or activities. 

Round to the nearest $100.

$ | | |, | | | |

D13. How much do you agree or disagree with each of the following statements?

MARK ONE BOX IN EACH ROW

STRONGLY 

DISAGREE

DISAGREE AGREE 

STRONGLY 

AGREE 

a. The district’s principal performance 

measures are an accurate measure of my

performance .....................................................

1  2  3  4 

b. The district’s principal performance 

measures are fair .............................................

1  2  3  4 

c. The district’s principal performance 

measures are used to support principal 

improvement.....

1  2  3  4 
E1. Has the [Program Name] affected your choice of where to work as a school 

administrator?

1  Yes

0 No GO TO QUESTION E3

E2. How has the [Program Name] affected your choice of where to work as a school 

administrator?

MARK ONE ONLY

1 I stayed at my school because of the [Program Name]

2 I came to my school to get into the [Program Name]

E. THE [PROGRAM NAME]
E3. Tell us about the professional development activities in which teachers at your school 

participated during the 2014-2015 school year. 

For each topic listed, indicate the following:

A: Was the topic the focus of professional development (PD) in which teachers 

participated?

B: If yes, approximately what percentage of teachers at your school received PD in the 

topic?

C: In general, to what extent do you feel the PD was beneficial to the participants?

IN EACH ROW, MARK ONE BOX IN COLUMN A. IF YES, COMPLETE COLUMNS B

AND C.

A. FOCUS OF PD?

B. PERCENT 

OF 

TEACHERS

C. PERCEIVED BENEFIT OF THE PD

YES NO

NOT 

AT ALL SLIGHTLY

SOMEWHAT HIGHLY

a Understanding components of 

the [Program Name] .................. 1  0  | | | | 1  2  3  4 

b. Understanding performance 

measure used as part of the 

[Program Name] ........................ 1  0  | | | | 1  2  3  4 

c. Direct feedback based upon 

individual performance ratings 

as measured by the [Program 

Name].......................................... 1  0  | | | | 1  2  3  4 

d. Differentiated instructional 

strategies based on student 

assessments ............................... 1  0  | | | | 1  2  3  4 

e. Instructional techniques and 

strategies..................................... 1  0  | | | | 1  2  3  4 

f. Aligning curricula to state or 

district standards ......................... 1  0  | | | | 1  2  3  4 
E4. Please indicate the extent to which you agree or disagree with each statement about

the [Program Name] at your school.

MARK ONE BOX IN EACH ROW

STRONGLY 

DISAGREE DISAGREE AGREE

STRONGLY 

AGREE

a. The [Program Name] has been clearly 

communicated to me................................................................1  2  3  4 

b. This school has less chance of earning a bonus 

because of the characteristics of our student 

population...................................................................................

1  2  3  4 

c. The evaluation system omits important aspects of 

school administration that should be considered .......................

1  2  3  4 

d. The [Program Name] contributes to greater 

collegiality and professionalism among the staff at

this school ..................................................................................

1  2  3  4 

e. Teachers at this school are more comfortable with 

formal observations of their teaching because of 

the [Program Name] ................................................................

1  2  3  4 

f. Parents and the school community believe the 

[Program Name] is important....................................................

1  2  3  4 

g. The [Program Name] is likely to continue for the 

foreseeable future ................................................................

1  2  3  4 

h. I played an important role in implementing the 

[Program Name] at my school .................................................. 1  2  3  4 
F1. In 2015-16, I have the potential to earn additional pay 

MARK ONE PER ROW

YES NO

a. Based solely on performance (e.g., measured by student 

achievement growth, observations, or a combination of measures) ......... 1 □ 0□

b. Based on performance measured by student achievement growth........... 1 □ 0□

c. Based on performance measured by observations ................................ 1 □ 0□

d. Based on my school’s characteristics (e.g., schools serving large 

proportions of economically disadvantaged or low-performing 

students) ................................................................................................ 1 □ 0□

e. For taking on additional roles or responsibilities in the school or 

district......................................................................................................... 1 □ 0□

F2. How much do you agree or disagree with each of the following statements?

MARK ONE BOX IN EACH ROW

STRONGLY 

DISAGREE

DISAGREE AGREE 

STRONGLY 

AGREE 

a. The district should provide additional pay 

based on principal performance in 2015-

16................

1  2  3  4 

b. The district should use student achievement 

growth to measure principal performance in 

2015-16 ..........................................................

1  2  3  4 

c. The district should use multiple 

observations to measure principal

performance in 2015-16..... 1  2  3  4 

F. THE [PROGRAM NAME]/ PERFORMANCE EVALUATION in 2015-16
F3. How much do you agree or disagree with each of the following statements?

MARK ONE BOX IN EACH ROW

STRONGLY 

DISAGREE

DISAGREE AGREE 

STRONGLY 

AGREE 

a. The district should provide additional pay 

based on teacher performance in 2015-

16................

1  2  3  4 

b. The district should use student achievement 

growth to measure teacher performance in 

2015-16 ..........................................................

1  2  3  4 

c. The district should use multiple 

observations to measure teacher

performance in 2015-16...... 1  2  3  4 

F4. If you have any additional thoughts you would like to share about the [Program Name]

or clarifications on your responses, please use the space below.
G1. Please provide your contact information below. We will use it to reach you in case we 

need to clarify any of your responses. We will also use the address to mail your check 

if you would like to receive it at an address other than your school address.

Providing this information is voluntary.

Name:______________________________________________________________________

Street address:______________________________________________________________

City:____________________________ State:___________________ Zip Code:_________

Home Telephone: | | | |-| | | |-| | | | |

Area Code Number

Cell Phone: | | | |-| | | |-| | | | |

Area Code Number

Work email:_________________________________________________________________

Home email:_________________________________________________________________

Best time to reach you by phone: Day: ______________________ Time: ________________ 

G2. A follow-up questionnaire will be sent to you at your school next year. Please provide 

the name and contact information of someone who will know how to reach you if you 

are no longer at your current school.

Providing this information is voluntary.

Person’s Name: ______________________________________________________________

Relationship to you: ___________________________________________________________

Street address: ______________________________________________________________

City:_______________________________ State:_________________ Zip Code: ________

Home Telephone: | | | |-| | | |-| | | | |

Area Code Number

Email: _____________________________________________________________________

Thank you for completing this questionnaire. 

G. CONTACT INFORMATION