School Information Sheet

Exhibit E

The Effects of Odyssey® Math Software

on the Mathematics Achievement of Selected Fourth Grade Students in the Mid-Atlantic Region: A Multi-Site Cluster Randomized Trial

School Information Sheet

Thank you for your interest in our research study. Please fill out this form so that we can learn more about your school. Simply fill in the form and fax your responses to: <number>. If filling this out electronically, please send the form to: <email>

You might find some sections have already been completed. When possible, we gathered what data we could via an Internet search. If sections are already complete, please verify the accuracy of the information and change is needed.

School Name:

District Name:

School Address:

City: Sate: Zip:

Your Name: Title:

What is your preferred email address?

What grade levels are at this site? (e.g., 1-6):

How many fourth grade classrooms are in this school?

What is the average number of fourth grade students in each class?

Do any of your fourth grade students teach only mathematics? Yes/No

What Mathematics Textbooks is the school using for fourth graders?

Do your fourth grade classrooms have access to computer labs with 1:1 student to computer ratios?

What is your school’s Bandwidth? _______________________________

What operating systems do your computers run on (e.g., Mac, Windows XP)?

___________________________________________________________

What math textbook curricula are you using in the fourth grade?

What typical instructional time is allocated to mathematic each week?

What other mathematics instructional materials are your fourth grade classes using?

What specific mathematics initiatives or special programs is your school using?

Please describe them: