Control Teacher Data Form - 2009

Adult ESL Literacy Impact Study

Control Teacher Data Form (2009)

Program Name: Site:

Last Name: First Name:

Address: Apt #:

Zip code:

Phone #: (______) _______ ___________

Classes taught at this program: ___________________________________________________

Name of Class in Study: ___________________ Meeting Days: _________ Meeting Times: ________

A. Professional Development

What is the total number of hours you spent participating in professional development workshops during summer 2008 through spring 2009 that covered the following topics?

If you attended professional development that falls under multiple categories, please divide the number of hours you estimate was spent on each topic.

Round to nearest whole hour. Write ‘0’ if you participated in none; please fill in all boxes.

	Number of hours (Write ‘0’ if you participated in none)
a. Teaching reading or general training on literacy instruction for ESOL learners
b. Teaching reading or general training on literacy instruction for non-ESOL learners
c. Teaching general ESOL (oral communication skills, pronunciation, vocabulary, etc.)
d. Other (specify): _______________________________________

B. Use of Instructional Materials

During the fall 2008 and winter/spring 2009 terms, to what extent, on average, did you use the following materials with your study class? (mark (X) each box that applies)

	Not used in study class	Used less than once a month	Used one to two times a month	Used three to four times a month	Used more than once a week
A workbook or text, or handouts from a workbook or text. Specify: ______________________________________	0 	1 	2 	3 	4 
An additional workbook or text, or handouts from an additional workbook or text. Specify: ______________________________________	0 	1 	2 	3 	4 
Worksheets that I or another teacher created	0 	1 	2 	3 	4 
Stories or paragraphs that I or another teacher created	0 	1 	2 	3 	4 
Stories or paragraphs that students created	0 	1 	2 	3 	4 
Stories or paragraphs from other sources (e.g., other publishers, newspapers)	0 	1 	2 	3 	4 
Dictionaries or picture dictionaries	0 	1 	2 	3 	4 
Computer software	0 	1 	2 	3 	4 
E-mail or webpages	0 	1 	2 	3 	4 
Audio recordings	0 	1 	2 	3 	4 
Video recordings	0 	1 	2 	3 	4 

You are done with the survey. Thank you.

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