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 Fund (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 retention. 

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 the 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 

Information; 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 instructions 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. 

Thank 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 

Background and Demographic Information for Educators (Teachers and Principals) 

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 

7 Highest degree held 

8 Certification status 

9 Score on licensure or certification test (include 

name of test and date administered) 

Year-Specific Information (2014–2015) 

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 Employment Category—principal or 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 (2014–2015) 

26 First criterion used (type of measure and name) 

27 Date first criterion administered or collected 

28 Score on first criterion (include information on 

type 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 used (type 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 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).

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, 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.