WWC Evaluator Registration

What Works Clearinghouse Database Forms and Customer Survey

Form06_EvaluatorRegistration_rev

WWC Evaluator Registration

OMB: 1850-0788

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1850-0788 can be found here:

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Thank you for choosing to submit your registration information to the What Works Clearinghouse Registry of Outcome Evaluators. Potential sponsors and users of evaluation studies that seek evidence of effectiveness about educational interventions will search this Registry in order to access information about individual and organizational providers who have outcome evaluation experience and who commit to standards of evidence established by the What Works Clearinghouse. We encourage you to review these standards before completing and submitting a registration form for inclusion in this Registry. If your registration form is complete, we will provide you with a letter of commitment and permission (pdf) that you must read and to which you must agree before your information will be searchable from the public site.

We encourage you to print a paper copy of this form in order to review all of the required information before completing the online registration form. If you have questions about filling out this form, or prefer to submit this information in paper form, please contact us at:

What Works Clearinghouse
2277 Research Boulevard, MS 6M
Rockville, MD 20850
Email: [email protected]
Phone: 1-866-WWC-9799
Fax: 301-519-6760

Please indicate if you are submitting a registration form to be considered for inclusion in the Registry of Outcome Evaluators as an individual or for an organization that employs two or more staff members who provide evaluation-related services:

1. Individual Evaluator 2. Organization

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1850–0788. The time required to complete this information collection is estimated to average 120 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. 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, D.C. 20202–4700. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Susan Sanchez, U.S. Department of Education, Institute of Education Sciences, Room 500G, 555 New Jersey Avenue, NW, Washington, DC, Washington, D.C. 20208.

The information in the Registry of Outcome Evaluators is supplied solely by the evaluators themselves. Neither the What Works Clearinghouse (WWC) nor the U.S. Department of Education endorses any individuals or organizations listed in the Registry. The WWC does not verify the accuracy of the information submitted by the evaluators nor does it assess their qualifications.

INDIVIDUAL EVALUATOR DATA COLLECTION FORM

1. Evaluator Name: _______________________________________________________________

Title: ____________________________________________________________________________

Organization 1 (if applicable): ________________________________________________________

Organization 2 (if applicable): __________________________________________________________

Address 1: ____________________________________________________________________________

Address 2: ____________________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: ___________________________

Country: _______________________________________________________________________________

Phone: ( ) - Fax: ( ) - E-mail: _______________________________

URL: http://____________________________________________________________________________

2. Indicate the number of years of experience you have had with each type of evaluation service below.

Evaluation Services	Number of years of experience
Studies of Causal Inference
Experimental designs¹
Quasi-experimental designs²

¹Experimental designs: Randomly assign individuals to groups

²Quasi-experimental designs: Allow individuals to self-select into groups or put them into groups on the basis of a characteristic related to the outcome variable but using matching or statistical procedures to equate treatment and control groups, such as regression discontinuity, interrupted time series, and econometric models, among others

3. What is the geographic availability of your evaluation service? (Select all that apply)

□ National

□ Regional:

􀂉All
􀂉Great Lakes/Midwest
􀂉North Central
􀂉Northwest
􀂉Southeast
􀂉South Central
􀂉Southwest
􀂉Other (please specify): ________________

□ State or Foreign State/Province

□ Local: Specify _________________________

4. List up to three (3) projects under each of the two (2) study types below (up to six (6) projects total) with which you have evaluation experience.

Study Type:

□ Experimental Design

□ Quasi-experimental Design

Project Name: _________________________________________________________________

Populations included in study: ______________________________________________________

Outcomes measured: _____________________________________________________________

Start date: MM/DD/YYYY End Date: MM/DD/YYYY

Sponsoring Organization: __________________________________________________________

Sponsor Contact Name: ___________________________________________________________

Address 1: ______________________________________________________________________

Address 2: ______________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: _________________

Country: _______________________________________________________________________

Phone: ( ) - Fax: (___)____-_________ E-mail: ___________________

□ Check here if confidentiality provisions prevent you from including a full listing of examples and you would like potential sponsors and/or users of evaluation studies to contact you for further information regarding relevant studies you have conducted.

5. Indicate the content area(s) that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)

􀂉Adult Basic Education (ABE)
􀂉Adult Literacy
􀂉Algebra
􀂉Arithmetic
􀂉Arts
􀂉Beginning Reading
􀂉Bilingual Education
􀂉Biology
􀂉Botany
􀂉Calculus
􀂉Career Education
􀂉Character Education
􀂉Chemistry
􀂉Civics
􀂉Computer Science
􀂉Earth Science
􀂉Economics
􀂉English
􀂉English (Second Language)
􀂉Environmental Education
􀂉Fine Arts
􀂉Fluency
􀂉Foreign Languages
􀂉General Educational Development (GED)
􀂉Geography
􀂉Geology
􀂉Geometry
􀂉Government
􀂉Graphic Arts
􀂉Health
􀂉History
􀂉Humanities
􀂉Language Arts
􀂉Limited English Speaking
􀂉Listening
􀂉Literature
􀂉Mathematics
􀂉Music
􀂉Natural Science
􀂉Phonemic Awareness
􀂉Phonics
􀂉Physical Education
􀂉Physics
􀂉Probability
􀂉Psychology
􀂉Reading
􀂉Reading Comprehension
􀂉Reading Strategies
􀂉Science
􀂉Second Languages
􀂉Social Studies
􀂉Sociology
􀂉Speech Communication
􀂉Statistics
􀂉Technology
􀂉Theater Arts
􀂉Trigonometry
􀂉Visual Arts
􀂉Vocational Education
􀂉Writing (Composition)
􀂉Other (Specify): __________

􀂉Not Applicable

6. Indicate other characteristics that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)

􀂉Ability Grouping
􀂉Accountability
􀂉Advanced Placement
􀂉After School Programs
􀂉Alternative Teacher Certification
􀂉Attendance
􀂉Behavior Problems
􀂉Class Size
􀂉Classroom Techniques
􀂉Compensatory Education
􀂉Comprehensive School Reform
􀂉Computer Assisted Instruction
􀂉Computer Uses in Education
􀂉Crime Prevention
􀂉Curriculum
􀂉Distance Education
􀂉Dropout Prevention
􀂉Educational Technology
􀂉Extended School Year
􀂉Grouping (Instructional Purposes)
􀂉High School Equivalency Programs
􀂉Individualized Education Programs
􀂉Instructional Materials
􀂉Lifelong Learning
􀂉Parent Participation
􀂉Preservice Teacher Education
􀂉Professional Development
􀂉Scheduling
􀂉School Choice
􀂉School Readiness
􀂉School Size
􀂉Socialization
􀂉Student Behavior
􀂉Student Motivation
􀂉Substance Abuse Prevention
􀂉Summer School
􀂉Teacher Education
􀂉Teacher Effectiveness
􀂉Teacher Training
􀂉Technology
􀂉Textbooks
􀂉Transportation
􀂉Truancy Prevention
􀂉Year Round Schools
􀂉Other (Specify): __________________

􀂉Not Applicable

7. Indicate the target population(s) that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)

Student Gender

􀂉Female Students
􀂉Male Students

Student Race/Ethnicity

􀂉American Indian or Alaska Native
􀂉Asian
􀂉Black or African American
􀂉Hispanic or Latino
􀂉Native Hawaiian or Other Pacific Islander
􀂉White

Student Level(s) of Education:

􀂉Preschool
􀂉Kindergarten
􀂉Elementary School
􀂉Middle School
􀂉High School
􀂉Postsecondary Education
􀂉Vocational/Career Education
􀂉Adult/Continuing Education

Student Disability

􀂉Developmentally Disabled Students
􀂉Emotionally Disabled Students
􀂉Hearing-Impaired Students
􀂉Learning Disabled Students
􀂉Physically Disabled Students
􀂉Students with Multiple Disabilities
􀂉Vision-Impaired Students
􀂉Speech-Impaired Students

Student Language

􀂉Limited English Proficient

Student Risk/Disadvantage

􀂉At Risk/Disadvantaged Students

􀂉Other (Specify): ________________

􀂉Not Applicable

Urbanicity

□ Rural □ Suburban □ Urban □ Not Applicable

8. What type(s) of degrees(s) have you earned? (Select all that apply.)

Discipline or Field	BA/BS	Masters	Doctorate
Computer Science/IT	□	□	□
Economics	□	□	□
Education	□	□	□
Mathematics	□	□	□
Public Policy	□	□	□
Psychology	□	□	□
Psychometrics	□	□	□
Sociology	□	□	□
Statistics	□	□	□
Other	□	□	□

9. List up to five (5) relevant reports or publications that best illustrate your evaluation experience.

Resource Type:

□ Published/Unpublished Report □ Book/Thesis □ Chapter in a Book □ Journal Article

Report Title: _____________________________________________________________

Author(s): ____________________________________________________________________

Year: _______ Publisher (if applicable): __________________________________________

URL: http://____________________________________________________________________

Book/Thesis Title: _____________________________________________________________

Author(s): ____________________________________________________________________

Year: _______ Publisher (if applicable): _______________________________

URL: http://____________________________________________________________________

Chapter Title: __________________________________________________________________

Book Title: _____________________________________________________________

Author(s): _____________________________________________________________________

Publication Year: _______ Publisher: ____________________________________________

Page number: _______

URL: http://____________________________________________________________________

Journal Article Title: ____________________________________________________________

Journal Title: __________________________________________________________________

Journal Volume/Issue Number (if applicable): ________________________________________

Page number: _______

Publication Date: ___________________________

URL: http://____________________________________________________________________

If study is not published, click here to submit an electronic copy of the study description or report.

URL: http://___________________________________________________________________

ORGANIZATION EVALUATOR DATA COLLECTION FORM

1. Contact Name: ________________________________________________________________________

Title: ___________________________________________________________________

Organization 1: _________________________________________________________________________

Organization 2: _________________________________________________________________________

Address 1: ______________________________________________________________________________

Address 2: ______________________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: ________________________

Country: _______________________________________________________________________________

Phone: ( ) - Fax: (___)_____________ E-mail: _________________________

URL: http://_____________________________________________________________________________

2. List below the total number of professional staff in your organization who fall into each category of years of experience.

Evaluation Services	Number of Staff with Experience by Number of Years Experience
	1 to 5 Years	6 to 9 Years	10 to 19 Years	20 or more Years
Studies of Causal Inference
Experimental designs¹
Quasi-experimental designs²

¹Experimental designs: Randomly assign individuals to groups

3. What is the geographic availability of your evaluation service? (Select all that apply)

□ National

□ Regional:

􀂉All
􀂉Great Lakes/Midwest
􀂉North Central
􀂉Northwest
􀂉Southeast
􀂉South Central
􀂉Southwest
􀂉Other (please specify): ________________

□ State or Foreign State/Province

□ Local: Specify _________________________

4. List up to seven (7) projects under each of the two (2) study types below (up to fourteen (14) projects total) with which your organization has experience.

Study Type