Student Survey of Motivation

Appendix H: Student Survey of Motivation

Appendix H, Page 1

OMB No. 0000-0000
Expiration Date: xx/xx/xxxx

Classroom Assessment FOR Student Learning Study

Student Survey of Motivation
Teacher Instructions
TEACHERS: PLEASE READ THE BELOW INSTRUCTIONS ALOUD TO YOUR STUDENTS BEFORE
HANDING OUT THE FORMS.

We would like to ask you to respond to some sentences about your feelings about math.
The information will be used in a study of math achievement.
We hope that you will respond to all the sentences, but if you don’t want to respond to a
sentence you do not have to. Responding to all the sentences should take you about 10
minutes.
Do not put your name on the form. No one in your family or your school will know how
you answer these questions. There are no right or wrong answers.
Use a regular number 2 pencil to fill out the form. For each sentence, fill in the box for
the answer that says how true the sentence is for you. Fill in the box you choose
completely; don’t mark it with an ‘X’ or a check mark.
Thank you for letting us know how you feel about math!
Teachers: please make sure your students fill in the boxes correctly. If there are
words the students do not understand, you may explain the words to them.
Thank you for your time! If you have any questions about this survey, please contact
Dr. Andrea Beesley, Study Director. She can be reached at REL Central at 303-6325541 or by email at [email protected].

Adapted from IRRE. (1998). Research Assessment Package for Schools (RAPS) Manual. Available at
http://www.irre.org/publications/pdfs/RAPS_manual_entire_1998.pdf and Midgley, C., Maehr, M. L., Hruda, L. Z.,
Anderman, E., Anderman, L., Freeman, K. E., et al. (2000). Manual for the Patterns of Adaptive Learning Scales
(PALS). Ann Arbor, MI: University of Michigan.
The U.S. Department of Education wants to protect the privacy of individuals who participate in surveys. Your answers will be
combined with other surveys, and no one will know how you answered the questions. This survey is authorized by law (1) Sections
171(b) and 173 of the Education Sciences Reform Act of 2002, Pub. L. 107-279 (2002); and (2) Section 9601 of the Elementary and
Secondary Education Act (ESEA), as amended by the No Child Left Behind (NCLB) Act of 2001 (Pub. L. 107-110). 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.
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 xxxx-xxxx. The time required to
complete this information collection is estimated to average 10 minutes per respondent, including the time to review instructions,
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 write to: U.S. Department of Education, Washington, DC 202024651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Sandra
Garcia, Institute of Education Sciences, 555 New Jersey Avenue, S.W., Room 506C, Washington, D.C. 20208-4651.

Appendix H, Page 2

OMB No. 0000-0000
Expiration Date:
xx/xx/xxxx

Classroom Assessment FOR Student Learning Study

Student Survey of Motivation

-Read each of the following sentences. For each one, show us how true it is for YOU by filling in the
box below one of the four answers: Very True, Sort of True, Not Very True, or Not at All True.
-There are no right or wrong answers.
-Use a regular No. 2 pencil.
-Fill in the boxes like this:
-Not like this:

Very
True

Sort of
True

Not
Very
True

Not at
All True

1. I work very hard on my math work.
2. I do my math homework because I like to do it.
3. I work on my math classwork because it’s interesting.
4. I’m certain I can figure out how to do the most difficult math work.
5. I don’t try very hard in math.
6. I do my math homework because I want to understand the subject.
7. I can do almost all the work in math if I don’t give up.
8. I work on my math classwork because I think it’s important.
9. I’m certain I can master the skills taught in math this year.
10. I pay attention in math class.
11. I work on my math classwork because I want to learn new things.
12. I do my math homework because it’s fun.
13. I can do even the hardest work in math class if I try.
14. I don’t work very hard in math.
15. I do my math homework because I want to learn new things.
16. Even if the math work is hard, I can learn it.
17. When I’m in math class I just act as if I’m working.
18. I work on my math classwork because doing well in math is important to
me.
19. I work on my math classwork because it’s fun.
Choose the answer that best describes how important it is to
do your best in math.

Very
Important

Sort of
Important

Not Very
Important

Not at All
Important

20. How important is it to you to do the best you can in math?

Appendix H, Page 3