**APPENDIX D** 

**PRINCIPAL AND TEACHER ADMINISTRATIVE DATA REQUEST LETTER PRINCIPAL/TEACHER DATA REQUEST** 

Dear [DISTRICT CONTACT]:
We would like to thank your district for participating in the National Evaluation of the Teacher Incentive Fun d (TIF) conducted in previous years 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 ret ention. We greatly

appreciate your assistance with this important study.
As part of the study, we are collecting information from district records about the participating principals and teachers in the study schools. These data will be used to document t he hiring, movement between schools, and attrition of principals and teachers participating in the study. We also want to obtain information on principals and teachers measured effectiveness and actual payouts to staff in recognition of their accomplishments. Finally, we are requesting any demographic or background characteristics available in your district files. Please note that cooperation with these activities is a condition of your grant (Office of Elementary and Secondary Education: Overview Informati on; Teacher Incentive Fund: Notice Inviting Applications for New Awards for Fiscal Year (FY) 2010, 75 FR 28740

- 28749 (May 21, 2010)).
The attached table indicates the specific items that we are requesting for the current school year. Also attached are in structions for returning the data to us. You can choose among three ways of returning the data: (1) posting the files to our secure website; (2) emailing the password

- protected files to us; or (3) sending the hard copy lists to us via Federal Express.

Th ank you very much for your assistance. A member of our study team will contact you in the next week to determine if you have any questions. You can reach me at (xxx) xxx

- xx or

xxxxxxxxxxxxxxxx

. Sincerely
,

xxxxxxxxxxxxxxxxxxxx**Item # Data Item** 

**Back ground and Demographic Information for Educators (Teachers and Principals)**  1 La st and first name 2 Sex 3 District ID number 4 Date of birth (mm/dd/yy) 5 Ethnicity (Hispanic or Latino origin) 6 Race 7 Highest degree held 8 Certificat ion status 9 Score on licensure or certification test (include name of test and date administered) **Year**

**- Specific Information (201**  **4**

**– 201**  **5 )**  10 School ID 11 School name 12 Date started at school (mm/dd/yy) 13 Date of Departure (if applicable) (mm/dd/yy) 14 Part

- time/Full

- time status 15 Itinerant indicator (splits time between multiple buildings) 16 Transfer during the year indicator 17 Number of years teaching experience (including current year) 18 Employ ment Category

— principal o r teacher 19 Grade taught (if teacher) 20 Self

- contained of subject

- area teacher (if teacher) 21 Subject taught (if applicable) 22 Number of days absent during the year 23 Eligible for performance pay (yes/no) 24 Maximum amount for which eligible 25 Actual amount of performance pay received **Information on Performance Measures (201 4** 

**– 201**  **5 )**  26 First criterion used (ty pe of measure and name) 27 Date first criterion administered or collected 28 Score on first criterion (include in formation on ty pe of score, possible range, passing score, etc.) 29 Second criterion used (type of measure and name) 30 Date second criterion administered or collected 31 Score on second criterion (same details as in #22) 32 Third criterion use d (ty pe of measure and name) 33 Date third criterion administered or collected 34 Score on third criterion (same details as in #22)**Notice of Confidentiality**

Responses to this data collection will be used only for statistical purposes. The report s 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 re quired 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).

According to the Pa perwork 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 in formation collection is estimated to average 8 hours per year, including the time to review instructions, gather the data needed, and c omplete 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 i ndividual submission of this form, w rite directly to: U.S. Department of Education, In stitute of Education Sciences, 555 New Jersey Avenue, NW, Wa shington, DC 20208.