Elementary (Grades 4-5) Student Questionnaire

Impact Evaluation of the DC Opportunity Scholarship Program

Att_Student -- Elementary for spring 2008

Elementary (Grades 4-5) Student Questionnaire

OMB: 1850-0800

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OMB #: 1850-0800

Expiration Date: 4/12/08








Evaluation of the DC Opportunity Scholarship Program


Elementary (Grades 4-5)

Student Questionnaire


Spring 2008

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 1850-0800 (expiration date: 4/12/08). The time required to complete this information collection is estimated to average 1/4 hour, including the time to review instructions, search existing data resources, gather the data needed, and complete the information collection. If you have any comments concerning the accuracy of the time estimate or suggestions for improving this form, please contact: Marsha Silverberg, U.S. Department of Education, Institute of Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208, [email protected]. If you have comments or concerns regarding the status of your individual submission of this form, e-mail directly to: [email protected].


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.




Please answer all the questions.

Part 1: About You

This first section asks about you.


Q1. Are you a ….


Boy 1

Girl? 2


Q2. How many people are living in your home, including you? _______________


Q3. Do you speak English at home?

( Check one)

Yes 1

No 2


Q4. Starting with first grade, how many schools have you gone to?

( Check one)


One school 1

Two schools 2

Three schools 3

Four or more schools 4


Q5. Do you mostly agree or mostly disagree with the comments below about yourself?

( Check one box on each row)



Mostly
agree

Mostly disagree

  1. I feel good about myself

1

2

  1. If I work really hard, I will do well in school

1

2

  1. Good luck is more important than hard work to do well in school

1

2

  1. I am able to do things as well as most other people

1

2

  1. Every time I try to get ahead, something or somebody stops me

1

2

  1. I am satisfied with myself

1

2

  1. When I make plans, I am almost sure I can make them work

1

2


Q6. How often do you read for fun?

( Check one)


Every day 1

Most days 2

Some days 3

Never 4


Q7. How far do you expect to go in school?

( Check one)


Some high school, but will not finish 1

Will finish high school 2

Some college, but will not finish 3

Will finish a 2 year college 4

Will finish a 4 year college 5

Will go to more school after college 6


Q8. Have you done any of these things this year?

( Check yes or no on each row)



Yes

No

  1. Took part in girl scouts or boy scouts

1

2

  1. Took part in groups at your church

1

2

  1. Played on team sports (like Little League)

1

2

  1. Went to religious services

1

2

Took classes in:



    1. Art, music, or dance

1

2

    1. Foreign language

1

2

    1. Religion

1

2

    1. Sports exercise or gym

1

2

  1. Helped work for the good of your community or volunteered at your school or in your community

1

2


Q9. On a regular school day, how long are you at home after school with no adult there?

( Check one)


Never, hardly ever 1

Less than 1 hour 2

1-2 hours 3

2-3 hours 3

More than 3 hours 4



Q10. How often do you talk to adults in your family about:

( Check one box on each row)



Often

Sometimes

Rarely

Never

Good things at school

1

2

3

4

Problems you face at school

1

2

3

4

Other topics that interest you

1

2

3

4


Q11. How many of your friends do your parents know by name?

( Check one)


All of them 1

Most of them 2

Some of them 3

None of them 4


Part 2: About Your School


This section asks about your school and your school experiences.


Q12. Do you agree or disagree with these statements about your school?

( Check one box on each row)



Agree strongly

Agree

Disagree

Disagree strongly

Students are proud to go to this school

1

2

3

4

Students learn a lot at the school

1

2

3

4

Rules about behavior are strict

1

2

3

4

When students misbehave, they receive the same treatment

1

2

3

4

I don’t feel safe

1

2

3

4

People at my school support me

1

2

3

4

I feel lonely at my school

1

2

3

4

I enjoy going to school

1

2

3

4


Q13. What overall grade would you give your school?

( Check one)


A-Excellent 1

B-Good 2

C-Fair 3

D-Unsatisfactory 4

F-Failing 5



Q14. Do you agree or disagree with these statements about the students and teachers in your school?

( Check one box on each row)



Agree strongly

Agree

Disagree

Disagree strongly

Students





  1. Students behave well in my classes

1

2

3

4

  1. Students neglect their homework

1

2

3

4

  1. In class, I often feel made fun of by other students

1

2

3

4

  1. Other students often disrupt class

1

2

3

4

  1. Students who behave badly often get away with it

1

2

3

4

Teachers





  1. Most of my teachers really listen to what I have to say

1

2

3

4

  1. My teachers are fair

1

2

3

4

  1. My teachers expect me to succeed

1

2

3

4

  1. Some teachers ignore cheating when they see it

1

2

3

4


Q15. Did the following ever happen to you at school this year?

( Check one box on each row)



Never

Once or twice

3 times or more

  1. Had something stolen from your desk, locker, or other place

1

2

3

  1. Had someone use force or threats to take money or things from you

1

2

3

  1. Been offered drugs

1

2

3

  1. Been physically hurt by another student

1

2

3

  1. Been threatened with physical harm

1

2

3

  1. Seen anyone with a real or toy gun or knife at school

1

2

3

  1. Been bullied at school

1

2

3

  1. Been called a bad name

1

2

3


Q16. How many times during the last two weeks were you:

( Check one box on each row)



Never

1 or 2 times

3 or 4 times

5 or more times

  1. Absent from school

1

2

3

4

  1. Late for school

1

2

3

4



Part 3: About Your Classes


This next section asks questions about the classes you are taking at school.


Q17. Do you agree or disagree with these statements about your classes this year?

( Check one box on each row)



Agree strongly

Agree

Disagree

Disagree strongly

Class work was hard to learn

1

2

3

4

I had trouble keeping up with the homework

1

2

3

4

I need more help from my teachers than I get

1

2

3

4

I understand what teachers explain in my class

1

2

3

4

Teachers encourage me to do my best

1

2

3

4


Q18. How many nights per week do you usually do homework?

( Check one)


Zero nights per week 0 Go to Question 20

1 night per week 1

2 nights per week 2

3 nights per week 3

4 nights per week 4

5 nights per week 5



Q19. How many minutes do you usually spend doing homework per day?


___________ (minutes)


Q20. During the past month, how often did your parents help you with your homework?

( Check one)


Never 1

Once 2

2-3 times 3

4-5 times 4

6 or more times 4


Part 5: About Private School Scholarships


This last section asks if you had a chance to attend a private school for free.



Q21. Did you receive a scholarship to go to a private school this year?

( Check one)


Yes 1 Go to Question 22

No 2 STOP – please hand in your survey

I Don’t Know 3 STOP – please hand in your survey


Q22. Were you involved in deciding whether to go to a private school?

( Check one)


Yes 1

No 2


Q23. Are you now going to a private school using the scholarship you were offered?

( Check one)


  1. Yes, I am now going to private school

1

STOP – please hand in your survey

  1. No, I was offered a scholarship to attend a private school but decided not to use it

2

Go to Question 24 on the next page

  1. No, I used the scholarship to attend a private school but I left that school

3

Go to Question 25 on the next page


Q24. If you were offered a scholarship to attend a private school but decided not to use it, why?

( Check all that apply)


  1. I did not want to leave my friends in public school

01

  1. My public school has sports that the private school(s) did not

02

  1. I thought the work might be too hard for me in the private school(s)

03

  1. There was no space at the participating private school I wanted to attend

04

  1. The private school(s) I was interested in were too far from my home or too hard to get to

05

  1. My public school teachers are better

06

  1. I got into a charter school

07

  1. I did not want to be held back a grade

08

  1. I did not want to have religious instruction

09

  1. I do not have to wear a uniform in public school

10

  1. The private school I wanted was not participating

11



STOP – please hand in your survey



Q25. If you used the scholarship to attend a private school but left that school during the year, why?

( Check all that apply)


  1. I did not like that private school

01

  1. The work at that private school was too hard

02

  1. The work at that private school was too easy

03

  1. It was too hard to get to that private school each day

04

  1. The discipline/rules were too strict at that private school

05

  1. I was unable to make friends in that private school

06

  1. The religious activities at that private school made me uncomfortable

07

  1. I wanted to return to my friends in public school

08

  1. I liked my public school better than that private school

09

  1. There was another private school I liked better

10



Thank you, please hand in your survey.


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