Form 01 SL Prevalence Study Survey Instrument. doc

N OMB No. # 3045 – XXXX Approval Expires: |___|___| - |___|___| - |___|___|___|___| MONTH DAY YEAR ATIONAL SURVEY OF SERVICE-LEARNING IN K–12 PUBLIC SCHOOLS, 2007–08
Sponsored by: Corporation for National and Community Service 1201 New York Avenue, NW Washington, DC 20525	Administered by: Westat 1650 Research Boulevard Rockville, MD 20850

Your school is one of a nationally representative sample of 2,000 schools selected to provide an important profile of community service and service-learning in our schools across the nation. The majority of the survey asks about the policies and practices in your school regarding service-learning activities. Definitions of community service and service-learning are provided in the next page. Thank you for your time and thought in taking part in this important study regardless of the amount of service-learning that may be taking place in your school.

Your confidentiality is assured. Reports of this survey will not contain the name of any respondent or school or school district, and survey responses will be delivered directly to Westat for analysis.

LABEL

IF THE ABOVE INFORMATION IS INCORRECT, PLEASE MAKE CORRECTIONS DIRECTLY ON THE LABEL.

Name of person completing form: Telephone:

Title/position:

Best days and times to reach you (in case of questions):

E-mail:

PLEASE RETURN YOUR COMPLETED FORM BY FRIDAY, APRIL 4, 2008:
MAIL IT IN THE ENCLOSED ENVELOPE TO: Kathy Morehead Westat 1650 Research Boulevard Rockville, MD 20850	OR FAX IT TO: Kathy Morehead Westat Fax: 1–888–XXX–XXXX	OR CALL (If you have questions or wish to complete this by phone): Kathy Morehead Westat Phone: 1–800–937–8281, ext. 5594

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 is 3045-XXXX. The average estimated burden time for the survey is 20 minutes, and 30 minutes for those directed to complete the full form. This estimate includes the time to review instructions, search existing data resources, 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 contact Corporation for National and Community Service, 1201 New York Avenue, NW, Washington, DC 20525.

I. Policies and Supports for Community Service

For the purposes of this survey, student community service is defined as community service activities that are non-curriculum-based and are recognized by the school. The community service:

• May be mandatory or voluntary;

• May be arranged by the school or other organizations;

• Generally does not include explicit learning objectives or organized reflection or critical analysis activities; and

• May include activities that take place off of school grounds or may happen primarily within the school.

Community service activities may be carried out as school-wide events, separately organized school programs, or school-sponsored projects conducted by other organizations, such as the Boys and Girls Club and National Honor Society. Examples of service activities could include cleaning up a local park, visiting the elderly, or collecting and distributing food to those in need.

1. Do your students participate in community service activities that fit the definition given above?

Yes 1

No 2 ( (If no, skip to Question 6.)

2. During this academic year, what percentage of the students in your school are or will be involved in community service, that is, involvement in organized volunteer service activities through the school? __________%

3. Do the community service activities take place during the school day, outside of school time, or both?

During school time only 1

Outside of school time only 2

Both during and outside school time 3

4. Does your school require students to participate in community service?

Yes, for all students 1

Yes, for some students 2

No 3

5. Does your school arrange community service opportunities for students?

Yes 1

No 2

II. Policies and Supports for Service-Learning

For the purposes of this survey, service-learning is defined as curriculum-based community service that integrates classroom instruction with community service activities. Like community service, service-learning may be mandatory or voluntary, and may have service activities that take place outside of or within the school. However, service-learning also:

• Is organized in relation to an academic course or curriculum;

• Has clearly stated learning objectives;

• Addresses real community needs; and

• Involves students in drawing lessons from the service through regularly scheduled, organized reflection or critical analysis activities, such as classroom discussions, presentations, or directed writing.

Example of service-learning: Students in a middle school science class studying the environment help preserve the natural habitat of animals living at a local lake. Through classroom studies, the students learn about the environment. The students keep the area around the lake clean, post signs providing information to the public, and study soil and water composition as well as the impact of industrial development on wildlife. Throughout the project, students write about their experiences in journals and participate in class discussions about the project and its effect on their lives and the local community.

6. Does your school have service-learning that fits the definition given above?

Yes 1 (If yes, skip to Question 7)

No 2

6a. If your school does not have service-learning activities, what are the reasons why? Circle all that apply.

a. State curriculum requirements do not allow time for service-learning 01	e. Teachers/staff lack training in service- learning 05
b. Local community lacks service opportunities for students 02	f. Our students are too young for service- learning 06
c. The school lacks funding or other resources 03	g. There is no one to coordinate the activities 07
d. Service-learning activities are in the planning stages 04	h. Other (specify) 08

6b. If your school does not offer service-learning activities, did your school offer service-learning, as defined above, at any time in the past ten years?

Yes 1

No 2

Don’t know 8

District-Level Policies and Supports

7. Does your school district have a written policy encouraging the integration of service-learning into the course curriculum in public schools?

Yes 1

No 2

8. Does your school district provide any of the following forms of assistance or support for service-learning in your school?

	Yes	No	Don’t know
Staff member who supports schools and teachers in using service-learning as an instructional approach	1	2	8
Training and/or professional development workshops for service-learning	1	2	8
Service-learning technical assistance materials or other publications	1	2	8
Listserv or other forms of on-line exchange about service-learning	1	2	8

If your school does not offer service-learning (the answer to Question 6 was No), skip to Question 21.

Service-Learning in your School

9. During this academic year, what percentage of the students in your school are or will be involved in service-learning, that is, service as part of a formal course or classroom activity?

_____________ % (If none, enter 0 and skip to Question 19)

9a. This percentage is:

Higher than 5 years ago 1

Similar to 5 years ago 2

Lower than 5 years ago 3

Don’t know 8

10. What percentage of the teachers in your school use service-learning as part of their instruction?

___________ %

11. How long have there been organized service-learning activities at your school?

One year or less 1	Six years or more 3
Two to five years 2	Don’t know 4

12. What best describes the scope of service-learning activities at your school during this academic year? Check all that apply.

School-wide (i.e., involving all students) 1	Multiple classrooms 4
Grade-wide (i.e., involving all students in a grade) 2	Single classroom 5
Discipline-wide (e.g., involving all social studies classes) 3	Co-curricular/extracurricular activities 6
	Other type of scope (specify) 7

13. In which curriculum areas is service-learning taking place?

Art/Music/Theater 01	Math 06	Vocational/Career Education 11
English/Language Arts 02	Physical Education 07	Advisory Period 12
Foreign Languages 03	Science 08	Elective 13
Gifted/Talented 04	Social Studies 09	Culminating/Capstone project 14
Health 05	Special Education 10	Other (specify) 15

School-Level Policies and Supports

14. Does your school have service-learning requirements for any of your students?

Yes, for all students 1

Yes, for some students 2

No 3

14a. If your school has a service-learning requirement for students, what type(s) of service-learning requirement(s) does your school have?

a. Specific number of courses that incorporate service-learning:	Yes 1	No 2
b. Specific number of hours of service outside the classroom:	Yes 1	No 2
c. Some other requirement:	Yes 1	No 2
(Please specify)

15. Please indicate whether the policies and practices listed below are in place at your school. For each type of policy, please indicate yes, no, or don’t know.

	Yes	No	Don’t know
a. Service-learning is recognized by the school as an improvement strategy in its strategic plan or improvement plan.	1	2	8
b. Service-learning is included in new teacher and/or staff orientation.	1	2	8
c. Service-learning is considered as one of the criteria for teacher/staff evaluations and/or in the performance standards for teachers/staff.	1	2	8
d. Students are involved in decision-making about the service-learning activities in the school (e.g. through an advisory council or other formal decision-making body).	1	2	8
e. Service-learning is part of the board-approved course curriculum in at least one subject in at least one grade in the school (if yes, answer 15e)	1	2	8

15e. If you answered yes to 15d, please indicate the subjects in which service-learning is part of the core curriculum.

a. Art/Music/Theater 01	f. Math 05	k. Vocational/Career Education 11
b. English/Language Arts 02	g. Physical Education 07	l. Advisory Period 12
c. Foreign Languages 03	h. Science 08	m. Elective… 13
d. Gifted/Talented 04	i. Social Studies… 09	n. Culminating/Capstone project 14
e. Health 05	j. Special Education 10	o. Other (specify) 15

16. Does your school have a full or part-time service-learning coordinator or staff person with responsibility for service-learning? (A coordinator is an individual whose efforts or support of service-learning go beyond his/her own classroom.)

Full-time coordinator 1

Part-time coordinator 2

No coordinator 3

17. To what extent are the following supports available at your school? Please indicate how regularly or widely each type is available.

	Never	Rarely	Occasionally	Frequently	Always
Financial support for planning, training, and/or implementation of service-learning projects	1	2	3	4	5
Reduction in teaching load to allow time for service-learning program development or supervision	1	2	3	4	5
Technical assistance on planning or implementation of service-learning activities	1	2	3	4	5
Recognition or rewards for teachers/staff for quality service-learning practices	1	2	3	4	5
Mini-grants for service-learning programs or curriculum development	1	2	3	4	5

18. What percentage of your teachers has received in-service training for service-learning since the 2002/03 school year?

__________ % (If none, enter 0.)

III. Other Support for Service-Learning and/or Community Service

19. Has your school received any special grants or other special funding to support service-learning activities in your school during this academic year?

Yes 1

No 2

Don’t know 8

20. Has your school received Learn and Serve America grant funds to support your service-learning activities during this academic year?

Yes 1

No 2

Don’t know 8

21. Has your school received Learn and Serve America grant funds at any time in the past?

Yes 1

No 2

Don’t know 8

22. Has your school received any special grants or other special funding to support community service activities in your school during this academic year?

Yes 1

No 2

Don’t know 8

22. Other than any funds granted through the Learn and Serve America program, please indicate whether your school received funding to support service-learning and/or community service activities from each of the following sources in the previous three years.

	Yes	No	Don’t know
a. AmeriCorps (including VISTA and NCCC)	1	2	8
b. State grants	1	2	8
c. Federal grants	1	2	8
d. Foundation grants	1	2	8
e. Corporate/business grants	1	2	8
f. School or district operating funds	1	2	8
g. Other (specify)	1	2	8

23. Are any of the following types of volunteers working with students on community service and/or service-learning activities during this academic year? (Circle one response for each item.)

	Yes	No	Don’t know
a. AmeriCorps (including VISTA and NCCC)	1	2	8
b. College Work Study (CWS)	1	2	8
c. Parents and/or family members	1	2	8
d. Adult volunteers who are not parents/family	1	2	8

IV. Background Questions about your School

24. Which grades does this school offer? (Circle all that apply)

Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12 Ungraded

25. How many full-time-equivalent (FTE) teachers are employed at your school?

______________ FTE teachers

26. What percentage of the students in your school is eligible for the federal aid program for free or reduced-price lunches?

______________ %

THANK YOU!

In case of follow-up for clarifications, would you please give us your name, telephone number, and E-mail address once again.

Name: Telephone:

E-mail:

PLEASE RETURN YOUR COMPLETED FORM BY FRIDAY, APRIL 4, 2008:
MAIL IT IN THE ENCLOSED ENVELOPE TO: Kathy Morehead Westat 1650 Research Boulevard Rockville, MD 20850	OR FAX IT TO: Kathy Morehead Westat Fax: 1–888–XXX–XXXX	OR CALL (If you have questions or wish to complete this by phone): Kathy Morehead Westat Phone: 1–800–937–8281, ext. 5594

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