SES Provider Survey

Feasibility and Conduct of an Impact Evaluation of Title I Supplemental Education Services

SES-OMB Appendix A June 04 09

SES Provider Survey

OMB: 1850-0858

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OMB Approval No.: 1850-0858
Approval Expires:
xx/xx/xxxx
MPR Reference No.: 6413-214

Supplemental Educational Services (SES) Provider Survey
June 4, 2009

Please answer the questions thinking about Supplemental Educational Services your
organization provides to students under the provisions of the federal No Child Left Behind in
the district named below during the 2008-2009 school year.

District Name:________________________________

Your responses to this data collection are protected from disclosure per the policies and
procedures required by the Education Sciences Reform Act of 2002, Title I, Part E, Section 183.
Responses to this data collection will be used only for statistical purposes. Mathematica Policy
Research (MPR) will present the information collected as part of this survey in an aggregate
form, and will not associate responses to any of the individual SES providers who participate.
MPR will not provide information that identifies you and your organization to anyone outside
the study team, except as required by law. Any willful disclosure of such information for
nonstatistical purposes, without the informed consent of the respondent, is a class E felony.

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 1850-0858. The time required to complete this
information collection is estimated to average 30 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 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 20202-4537.

Thank you for taking time to complete this questionnaire.
Your responses are very important to us.

INSTRUCTIONS
PLEASE READ THESE IMPORTANT INSTRUCTIONS
BEFORE COMPLETING THE QUESTIONNAIRE

All of your answers should focus on the Supplemental Educational Services provided by your organization to
students in the district named on the front cover of this questionnaire during the 2008-2009 school year.
If you serve students in more than one participating district, you will be sent a different questionnaire for each
district.
When answering questions that require marking a box, please use an “X.”
Follow all “GO TO” instructions after marking a box. If no such instruction is provided, you should continue to
the next question.
The contact information you supply at the end of the questionnaire will be used only if we have to contact you
for clarification about a particular response.
Return the completed questionnaire in the FedEx envelope provided. Include the completed check request
form as well.
If you no longer have the envelope, please mail the questionnaire and check request form to:

Mathematica Policy Research, Inc.
Attn: Project #6413
P.O. Box 2393
Princeton, NJ 08543-2393

If you have any questions about the study, please contact Karen Bogen, the MPR Survey Director, at
617-674-8355 or [email protected].

Thank you again for your participation in this important study.
.

Prepared by Mathematica Policy Research, Inc.

(5/28/09)

A. PROVIDER CHARACTERISTICS

A1.

A4.

Overall, about how many years has your
organization provided:
NUMBER OF
YEARS

Which of the following best describes your
organization?

a.

MARK ONE ONLY
1

 Faith-based organization

2

 Community-based organization

3

 For-profit company

4

 Charter school

5

b.

 Public school

7

 Private school (K-12)

8

 College or university

9

 Other (Please specify)

|

|

Other educational services
to students in this district? ........ |

|

|

(ENTER “0” IF YOU HAVE NEVER PROVIDED
THE SERVICE; ENTER “1” IF PROVIDED FOR
LESS THAN ONE YEAR)

 Public school district (including intermediate
agency)

6

SES to students in
this district? .............................. |

A5.

Focusing on the district listed on the front cover,
please indicate whether during the 2008-2009
school year your organization delivered SES in
each of the following locations, understanding
that some students may have received services
in more than one of these locations.
MARK “YES”
OR “NO”
FOR EACH

YES

A2.

In how many school districts did your
organization provide Supplemental Educational
Services (SES) to students during the 2008-2009
school year?
MARK ONE ONLY

a. At the student’s home (in-person
tutoring) ..........................................

1



0



b. At the student’s home (on-line
services) .........................................

1



0



1

 One district

c.

At the school of the served student

1



0



2

 2-5 districts

d. At other school district facilities ......

1



0



3

 More than 5 districts

e. At your organization’s own facility ..

1



0



1



0



f.
A3.

NO

In how many states did your organization
provide SES to students during the 2008-2009
school year?

At some other location (e.g., at
another facility such as a library or
community center) ..........................

MARK ONE ONLY
1

 One state

2

 2-5 states

3

 More than 5 states

Prepared by Mathematica Policy Research, Inc.

1

(5/28/09)

A6.

If your organization provided SES at locations other than the student’s home or school, please list the
address(es) of all of the locations where you provided SES for students in this district.

 MARK HERE IF YOUR ORGANIZATION PROVIDED SERVICES ONLY AT STUDENTS’ HOME OR SCHOOL, THEN SKIP TO A7

NUMBER AND STREET ADDRESS

CITY/TOWN

ZIP

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

(If you provided services in more than ten locations, please list the additional locations on the back cover of this
questionnaire.)

A7.

Did your organization offer transportation services to students in this district who attended SES during
the 2008-2009 school year?
MARK ONE ONLY
1

 Yes (either to sessions or returning home)

0

 No

Prepared by Mathematica Policy Research, Inc.

2

(5/28/09)

B. STAFF CHARACTERISTICS

B3.

B. STAFF CHARACTERISTICS
B1.

How many instructional staff members did your
organization use to provide SES in this district
during the 2008-2009 school year?
|

|

|

| NUMBER OF INSTRUCTIONAL STAFF

B4.

 Yes

0

 No

1

 Yes

0

 No

GO TO B5

How many hours of training do instructional
staff usually receive during their first year on
your organization’s SES program?
|

B2a. Are the instructional staff members of your
organization required to be certified school
teachers?
1

Does your organization provide instructional
staff with training on the curriculum, materials,
and instructional methods of your program?

|

| NUMBER OF HOURS OF TRAINING
DURING THEIR FIRST YEAR

B5.

GO TO B3

During the 2008-2009 school year, approximately
what percentage of your SES instructors were…
PERCENT

B2b. What is the minimum educational or professional
qualification required to be an instructional staff
person in your organization?
MARK ONE ONLY
1

2

3

4

 Prior experience as a school teacher
 Prior experience teaching or tutoring
academic content

a. …school teachers currently
employed in this district? ...............

|

|

|

|%

b. …school teachers who are not
currently employed in this district
(e.g., teachers employed by other
districts or retired teachers)? .........

|

|

|

|%

c. …enrolled as high school
students? ..........................................

|

|

|

|%

d. …enrolled as college students? .....

|

|

|

|%

NOTE: Might
not add to
100%

 Minimum score on assessment of content
mastery or teaching skills (for example,
Praxis, state licensure exam)
B6.

 Four-year college degree with academic
major, minor, or minimum number of
college credit hours in content area

5

 Any four-year college degree

6

 Some college coursework

7

 High school degree

8

 Other (Please specify)

Prepared by Mathematica Policy Research, Inc.

For your instructional staff providing SES to
students in this district, approximately how
many years of experience teaching and/or
tutoring do they have, on average?
|

B7.

|

| AVERAGE YEARS OF EXPERIENCE

For your instructional staff who provided SES to
students in this district, what is the…
RATE PER HOUR

3

a. Lowest hourly wage? ..............

$|

|

|

|.|

|

|

b. Highest hourly wage?..............

$|

|

|

|.|

|

|

c. Average hourly wage? ............

$|

|

|

|.|

|

|

(5/28/09)

C. SERVICES

Once again, questions in this section target those services offered in the district named on the front cover served
by your organization.
C1a. In this section of the questionnaire, we use the following categories for grade levels: primary elementary
grades, intermediate elementary grades, and middle school grades. The specific grades that would be
included in each of the three grade categories may vary by school district, since, for example, some
districts include 6th grade in intermediate elementary and others include it in middle school. Please list
which specific grades are included in each of the grade categories, based on the students you serve in the
district for which you are answering.
Grade Categories

Please circle the specific grades you will include in each category.
No grade should be included in more than one category.

a. Primary elementary grades..............................
K

1

2

3

4

5

6

7

8

b. Intermediate elementary grades ......................
K

1

2

3

4

5

6

7

8

c.

1

2

3

4

5

6

7

8

Middle school grades .......................................
K

C1b. During the 2008-2009 school year, for which individual subjects did your organization provide SES at the
different grade levels in this district?
MARK ALL THAT APPLY FOR EACH GRADE LEVEL

Primary
elementary
grades

Content Areas

Intermediate
elementary
grades

Middle school
grades

a. Reading/Language Arts/English ..................................

1



1



1



b. Mathematics .................................................................

2



2



2



c.

Social Studies/History ..................................................

3



3



3



d. Science.........................................................................

4



4



4



e. Writing ..........................................................................

5



5



5



f.

6



6



6



n



n



n



Other subjects (Please specify) ......................................

NO SES PROVIDED TO THESE GRADE LEVELS

C1c. During the 2008-2009 school year, in what other areas did your organization provide SES at the different
grade levels in this district?
MARK ALL THAT APPLY FOR EACH GRADE LEVEL

Primary
elementary
grades

Other Areas of Help

Intermediate
elementary
grades

Middle school
grades

a. Help with homework assigned by students’ school
teachers .......................................................................

1



1



1



b. Test-taking skills ...........................................................

2



2



2



c.

Study skills or organizational skills ...............................

3



3



3



d. Other (Please specify) ....................................................

4



4



4



NO SES PROVIDED TO THESE GRADE LEVELS

n



n



n



Prepared by Mathematica Policy Research, Inc.

4

(5/28/09)

C2.

During the 2008-2009 school year, did your
organization provide SES to each of the
following student populations in this district?

C3c. This school year, for how many participating
students in this district did your organization
receive examples of student work prior to
providing SES to them?

MARK “YES”
OR “NO”
FOR EACH

YES

MARK ONE ONLY
1

NO
2

a. Students with Individualized
Education Programs (IEPs, i.e.
students who are entitled to special
education services because they
have a disability) ..............................

1



0



4

b. Students with Limited English
Proficiency (LEP) .............................

1



0



5

3

C3a. Most students that you serve in grades 4
through 8 would have taken a state assessment
in the spring of the school year before they
enrolled in SES. Before starting the 2008-2009
services, for how many of your SES students in
grades 4-8 was your organization given any
prior-year state assessment scores from this
district?

C4a. In the 2008-2009 school year, did your
organization administer diagnostic assessments
to all, some, or none of the participating
students in this district, at the beginning of
their course of services?

MARK ONE ONLY
1

2

3

4

5

 Received student work for all or nearly all
of your SES students in this district
 Received student work for more than half
of your SES students in this district
 Received student work for about half of
your SES students in this district
 Received student work for less than half
of your SES students in this district
 Received student work for none of your
SES students in this district

 Received scores for all or nearly all of your
grade 4-8 SES students in this district
 Received scores for more than half of your
grade 4-8 SES students in this district
 Received scores for about half of your
grade 4-8 SES students in this district
 Received scores for less than half of
your grade 4-8 SES students in this district
 Received scores for none of your
grade 4-8 SES students in this district

1

 All

2

 Some

3

 None

GO TO C5

GO TO C6

C4b. Which SES students were given a diagnostic
assessment at the beginning of the course of
services?
MARK ALL THAT APPLY
1

2

C3b. This school year, for how many participating
students in this district did your organization
receive report card grades prior to providing
SES to them?

3

4

 Students in grades not given state
assessment or other standardized tests
 Students for whom you did not have
state assessment scores
 Students for whom you did not have
other standardized test scores
 Other students (Please describe)

MARK ONE ONLY
1

2

3

4

5

 Received grades for all or nearly all
of your SES students in this district
 Received grades for more than half
of your SES students in this district
 Received grades for about half of
your SES students in this district
 Received grades for less than half
of your SES students in this district
 Received grades for none of your
SES students in this district

Prepared by Mathematica Policy Research, Inc.

C5.

Were the diagnostic assessments developed by
your organization or purchased from a
publisher?
MARK ONE ONLY
1
2
3

5

 Developed by your organization
 Purchased from a publisher
 Combination of purchased and
self-developed

(5/28/09)

C6.

Think now about student learning plans, that is, the written, systematic plans that describe instruction
tailored to each student’s individual needs. Sometimes parents or teachers or school district officials
might be unable to participate in the development of the plan, in which case some students might not have
a student learning plan in place. During the 2008-2009 school year, what percentage of SES participants
from this district did your organization serve without a written student learning plan in place?
|

|

| % WITHOUT A STUDENT LEARNING PLAN

C7a. During the 2008-2009 school year, how many of the students’ parents or guardians contributed to the
development of students’ learning plans in each of the following ways?
MARK ONE IN EACH ROW

Most

Some

Few

None

parents/guardians
(more than 50%)

parents/guardians
(25-50%)

parents/guardians
(less than 25%)

of the parents/
guardians

a. Approved the plan but did not contribute
substantively to its development .............

1



2



3



4



b. Contributed substantively to the content
of the plan ...............................................

1



2



3



4



1



2



3



4



c.

No involvement in developing or
approving the plan...................................

C7b. During the 2008-2009 school year, how many of the students’ school teachers contributed to the
development of students’ learning plans in each of the following ways?
MARK ONE IN EACH ROW

Most

Some

Few

None

school teachers
(more than 50%)

school teachers
(25-50%)

school teachers
(less than 25%)

of the school
teachers

a. Approved the plan but did not contribute
substantively to its development .............

1



2



3



4



b. Contributed substantively to the content
of the plan ...............................................

1



2



3



4



1



2



3



4



c.

C7c.

No involvement in developing or
approving the plan...................................

Besides the school teachers of SES students, to what extent did any other staff from the student’s school
or district contribute substantively, beyond just final approval, to the content of students’ learning plans?
1
2
3
4

C8.






For most of the students (more than 50%)
For some of the students (25-50%)
For a few of the students (less than 25%)
For none of the students

Which of the following best describes your organization’s timing of assessments for SES students in this
district?
MARK ALL THAT APPLY
1
2
3
4






We used prior test scores provided by the district
We administered tests at the beginning, or “pre” services
We administered tests at the end of the year, or “post” services
We administered one or more additional tests in between “pre” and “post”

Prepared by Mathematica Policy Research, Inc.

6

(5/28/09)

C9.

In total, about how many times over the course of the year did you conduct assessments with your
typical Reading/Language Arts/English student and your typical Mathematics student?
IF YOU DO NOT DO ANY TESTING OR YOU RELY ONLY ON STATE OR DISTRICT PROVIDED SCORES, ENTER 0

________

Total number of Reading/Language Arts/English tests per year for typical SES student

________

Total number of Math tests per year for typical SES student

C10a. When choosing or developing curriculum and materials for instruction of SES participants in this
district, which of the following were important considerations (column A) and which was the single
most important consideration (column B)?
COLUMN A

COLUMN B

MARK ALL THE
IMPORTANT
CONSIDERATIONS

MARK THE SINGLE MOST
IMPORTANT
CONSIDERATION
(JUST ONE, PLEASE)

a. Nationally recognized standards in reading and mathematics
(e.g., National Council of Teachers of Mathematics or
National Council of Teachers of English) ...............................

1



1



b. Common standards across the states where we operate ......

2



2



c.

Standards of this state ............................................................

3



3



d. This school district’s curriculum materials ..............................

4



4



e. Other (Please specify) ...............................................................

5



5



C10b. On a scale of 0 to 10, how closely aligned do you think your curriculum is to the state standards?
CIRCLE ONE NUMBER ONLY

Not at all
aligned with
the state
0

Completely
aligned with
the state
1

2

3

4

5

6

7

8

9

10

Don’t know

C10c. On a scale of 0 to 10, how closely aligned do you think your curriculum is to this district’s curriculum?
CIRCLE ONE NUMBER ONLY

Not at all
aligned with
this district
0

Completely
aligned with
this district
1

2

3

Prepared by Mathematica Policy Research, Inc.

4

5

6

7

7

8

9

10

Don’t know

(5/28/09)

C11a. For each subject and grade level, please indicate the source(s) of the curriculum and materials you used
with participating SES students.
Source of Curriculum/Materials
MARK ALL THAT APPLY

Developed by
your
organization

Purchased
from publisher

Other

We didn’t provide
SES in this
subject/grade

Primary/Intermediate Elementary Grades
Reading/Language Arts/English .............

1



2



3



0



Mathematics ............................................

1



2



3



0



Reading/Language Arts/English .............

1



2



3



0



Mathematics ............................................

1



2



3



0



Middle School Grades

IF USED PUBLISHED CURRICULUM AND MATERIALS, PLEASE ANSWER C11b.
THOSE NOT USING PUBLISHED MATERIALS

GO TO C12

C11b. Please list the publisher’s name and title of all curriculum and materials that you used for Reading/
Language Arts/English and Math with SES students in this district. Note the subject and grade level
for which each was used.

Publisher Name

Title of Curriculum or Material

Subject area
(Reading/Language
Arts/English or
Math)

Grade
level(s) for
which this
material is
used

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
(Please use the back cover of this questionnaire if you need additional space.)

Prepared by Mathematica Policy Research, Inc.

8

(5/28/09)

C12. Which of the following teaching aids were used
in Reading/Language Arts/English SES?



C14. Please mark all of the descriptions that apply to
how individual SES sessions were handled by
instructional staff at your organization.

MARK HERE IF NO TUTORING IN READING/
LANGUAGE ARTS/ENGLISH
GO TO C13

MARK ALL THAT APPLY
1

MARK “YES” OR
“NO” FOR EACH

YES

a. Textbooks ....................................

1



0



b. Worksheets or workbooks ...........

1



0



c.

1



0



Computer software ......................

2

NO

4

3

d. Games .........................................

1



0



e. Flashcards ...................................

1



0



f.

Practice tests ...............................

1



0



g. Other (Please specify) ....................

1



0



5

 A standard curriculum with sequenced
materials that teaching staff cannot modify
 A standard curriculum that teaching staff
may vary in the sequencing of materials
as needed
 A standard curriculum that teaching staff
may vary in the amount of time spent on
specific content elements as needed
 A flexible curriculum that teaching staff
may vary in the content elements covered
as needed
 No set curriculum; teaching staff have
discretion to choose among a range of
materials depending on the needs of
their students

C15. What was the total number of SES hours a
student in this district could attend during
the course of the year?
C13. Which of the following teaching aids were used
in Mathematics SES?



Number of
hours per year

MARK HERE IF NO TUTORING IN
MATHEMATICS
GO TO C14
MARK “YES” OR
“NO” FOR EACH

YES

NO

a. Textbooks ....................................

1



0



b. Worksheets or workbooks ...........

1



0



c.

Computer software ......................

1



0



d. Games .........................................

1



0



e. Flashcards ...................................

1



0



f.

Practice tests ...............................

1



0



g. Math manipulatives ......................

1



0



h. Other (Please specify) ....................

1



0



Prepared by Mathematica Policy Research, Inc.

a. Primary elementary grades ..........

|

|

|

b. Intermediate elementary grades ..

|

|

|

c. Middle school grades ...................

|

|

|

C16. What was the duration of a typical SES session
offered to students in this district by your
organization? Please write in the average
number of contact minutes per session for each
of the grades below.
Minutes per
session

9

a. Primary elementary grades ..........

|

|

|

|

b. Intermediate elementary grades ..

|

|

|

|

c. Middle school grades ...................

|

|

|

|

(5/28/09)

C17. For the typical SES participant that you served in this district during the 2008-2009 school year, how many
weeks did it take to complete a full course of SES services?
|

|

| WEEKS

C18. How many times a week did the typical participant you served in this district attend SES sessions?
ENTER “0” IF NO TUTORING IN THE GRADE

_____ Times per week primary elementary grades

_____ Times per week intermediate elementary grades

_____ Times per week middle school grades

C19. What percentage of the SES provided by your organization to students in this district was:
ENTER “0” IF NONE.
PERCENT

a. Face to face instruction ....................................................... |

|

|

|%

b. Distance education (by phone, video, and/or
networked computer) .......................................................... |

|

|

|%

100%
TOTAL SHOULD
ADD UP TO 100%

C20. During the 2008-2009 school year, what percentage of your SES services to students in this district were
provided in each of the following ways?
ENTER “0” IF NONE.
PERCENT

a. In one-on-one sessions (NO other students present) ......... |

|

|

|%

b. In groups of 2 to 5 students ................................................ |

|

|

|%

c. In groups of 6 to 10 students .............................................. |

|

|

|%

d. In groups of more than 10 students .................................... |

|

|

|%

100%

Prepared by Mathematica Policy Research, Inc.

10

(5/28/09)

D. COMMUNICATION



D1.

IMPORTANT:
The items in this section ask about communications between your
organization and parents, school teachers, school staff, and district staff
regarding SES students.
We are interested in all means of
communication (written, phone, email, reports, etc.) that are about
individual students’ instructional matters (progress, performance, etc.).
Please do NOT include administrative or management communication
about things such as logistics and billing.

There are a number of different ways that your organization might have communicated with parents
about their child’s progress during the 2008-2009 school year. For each of these different ways of
communicating, about how often did a parent of a typical SES student receive information from you
regarding their child’s progress?
MARK ONE IN EACH ROW

At least once
a week

A few times a
month

At least once
a month

A few times a
year

Didn’t use this
mode of
communication

a. By telephone ................................

1



2



3



4



0



b. By email .......................................

1



2



3



4



0



c.

By regular mail .............................

1



2



3



4



0



d. In-person ......................................

1



2



3



4



0



e. Notes sent home with students ....

1



2



3



4



0



1



2



3



4



0



f.

D2.

Other mode of communication
(Please describe) ............................

When communicating with parents of students receiving SES, how often were the following addressed?

 MARK HERE IF NOT APPLICABLE BECAUSE STAFF MEMBERS DO NOT COMMUNICATE WITH PARENTS

GO TO D4

MARK ONE IN EACH ROW

At least
once a
week

A few
times per
month

At least
once a
month

A few
times a
year

Never

Don’t
know

a. Student attendance at SES sessions .......

1



2



3



4



5



d



b. Student behavior or motivation during
sessions ....................................................

1



2



3



4



5



d



c. Student progress (e.g., related to regular
classroom instruction or SES goals or
specific learning needs) ............................

1



2



3



4



5



d



Prepared by Mathematica Policy Research, Inc.

11

(5/28/09)

D3.

To what degree was each of the following a challenge to successful communication with parents in this
district?
MARK ONE IN EACH ROW

Not a
challenge

Minor
challenge

Moderate
challenge

Serious
challenge

a. Language barriers ..................................................

1



2



3



4



b. Work schedule of parent ........................................

1



2



3



4



c.

Work schedule of instructional staff members .......

1



2



3



4



d. Wrong, non-working, or disconnected phone
numbers for parents...............................................

1



2



3



4



e. Parent lack of access to email ...............................

1



2



3



4



1



2



3



4



f.

D4.

District inhibits or discourages communications
with parents ...........................................................

There are a number of different ways that your organization might have communicated with school
teachers of students receiving SES during the 2008-2009 school year. For each of these different ways
of communicating, about how often did a school teacher of a typical SES student receive information
from you regarding their student’s progress?
MARK ONE IN EACH ROW

At least once
a week

A few times
a month

At least once
a month

A few times
a year

Don’t use this
mode of
communication

a. By telephone ..............................

1



2



3



4



0



b. By email .....................................

1



2



3



4



0



c.

By regular mail ...........................

1



2



3



4



0



d. In-person ....................................

1



2



3



4



0



e. Notes left for the teacher ...........

1



2



3



4



0



1



2



3



4



0



f.

Other mode of communication
(Please describe)..........................

Prepared by Mathematica Policy Research, Inc.

12

(5/28/09)

D5.

When communicating with school teachers of students receiving SES, how often were the following
addressed in conversations or progress reports or any other communications?



MARK HERE IF NOT APPLICABLE BECAUSE STAFF MEMBERS
DO NOT COMMUNICATE WITH CLASSROOM TEACHERS
GO TO D7
MARK ONE IN EACH ROW

At least
once a
week

A few
times per
month

At least
once a
month

A few
times a
year

Never

Don’t
know

a. Student attendance at SES
sessions .....................................

1



2



3



4



5



d



b. Student progress related to
regular classroom instruction ....

1



2



3



4



5



d



c. Upcoming standardized tests ....

1



2



3



4



5



d



d. Student progress related to
SES activities or goals ...............

1



2



3



4



5



d



e. Academic topics addressed
most recently in students’ SES
services .....................................

1



2



3



4



5



d



Upcoming academic topics to
be covered in school..................

1



2



3



4



5



d



g. Student behavior or motivation
during sessions ..........................

1



2



3



4



5



d



h. Specific learning needs of the
student .......................................

1



2



3



4



5



d



f.

D6.

To what degree was each of the following a challenge to successful communication with school teachers
in this district?
MARK ONE IN EACH ROW

Not a
challenge

Minor
challenge

Moderate
challenge

Serious
challenge

a. Work schedule of the school teacher ............................

1



2



3



4



b. Work schedule of SES instructional staff members ......

1



2



3



4



c.

Teacher lack of access to a telephone ..........................

1



2



3



4



d. Teacher lack of access to email ....................................

1



2



3



4



e. Lack of information about how to reach teachers ..........

1



2



3



4



District inhibits or discourages communications with
teachers .........................................................................

1



2



3



4



g. Willingness of the school teachers to talk with you .......

1



2



3



4



f.

Prepared by Mathematica Policy Research, Inc.

13

(5/28/09)

D7.

During the 2008-2009 school year, about how often did staff members in your organization communicate
with anyone else in the school besides the child’s teachers (e.g., principals, guidance counselors, on-site
coordinators) about instructional progress of students receiving SES?
MARK ONE ONLY

D8.

1

 At least once a week

2

 A few times per month

3

 At least once a month

4

 A few times per year

5

 SES Staff members did not communicate with other school staff

d

 Don’t know

During the 2008-2009 school year, about how often did you or other staff members in your organization
communicate with district central office staff about SES students’ progress or performance?
MARK ONE ONLY

D9.

1

 At least once a week

2

 A few times per month

3

 At least once a month

4

 A few times per year

5

 SES staff members did not communicate with district central office

d

 Don’t know

On a scale of 0 to 10, how would you describe the relationship of the school district’s central office with
your organization regarding SES during the 2008-2009 school year?
CIRCLE ONE NUMBER ONLY

District was
difficult,
unresponsive,
adversarial

District was
supportive,
responsive,
collaborative

0

1

2

3

4

5

6

7

8

9

10

Don’t know

D10. Among the SES participants your organization served in the local district (that is, the district listed on the
front cover), how many different schools were they enrolled in?
|

|

|

|

NUMBER OF SCHOOLS IN THE LOCAL DISTRICT
THAT ENROLL SES PARTICIPANTS WE SERVED

Prepared by Mathematica Policy Research, Inc.

14

(5/28/09)

D11. Please mark which textbooks and curriculum
materials were used in the grades and subjects
listed below in schools in this district for the
2008-2009 school year.

D12. Who was primarily responsible for completing
this form? This information will be used only if we
need to contact you about your responses.

GRADE 3 Reading/Language Arts/English
1 
Publisher’s name, Title 1
2 
Publisher’s name, Title 2
3 
Publisher’s name, Title 3
4 
Publisher’s name, Title 4
5 
Publisher’s name, Title 5
6 
Other (Specify)

d

Name:
Title:
Phone Number:
Email Address:

 Don’t know

Thank you for your participation. Please return this
questionnaire and your check request form in the
envelope provided. If you no longer have the
envelope, please mail this questionnaire to:

GRADE 3 Mathematics
1 
Publisher’s name, Title 1
2 
Publisher’s name, Title 2
3 
Publisher’s name, Title 3
4 
Publisher’s name, Title 4
5 
Publisher’s name, Title 5
6 
Other (Specify)

d

MATHEMATICA POLICY RESEARCH, INC.
ATTN: Project #6413
P.O. Box 2393
Princeton, NJ 08543-2393

 Don’t know

GRADE 7 Reading/Language Arts/English
1 
Publisher’s name, Title 1
2 
Publisher’s name, Title 2
3 
Publisher’s name, Title 3
4 
Publisher’s name, Title 4
5 
Publisher’s name, Title 5
6 
Other (Specify)

d

 Don’t know

GRADE 7 Mathematics
1 
Publisher’s name, Title 1
2 
Publisher’s name, Title 2
3 
Publisher’s name, Title 3
4 
Publisher’s name, Title 4
5 
Publisher’s name, Title 5
6 
Other (Specify)

d

 Don’t know

Prepared by Mathematica Policy Research, Inc.

15

(5/28/09)

UNITED STATES DEPARTMENT OF EDUCATION
INSTITUTE OF EDUCATION SCIENCES
National Center for Education Evaluation and Regional Assistance

June 2009
Dear SES Provider:
The U.S. Department of Education has contracted with Mathematica Policy Research, Inc.
(MPR) to conduct an important study to evaluate the impact on student achievement of Supplemental
Educational Services (SES) under Title I of the Elementary and Secondary Education Act, as
reauthorized by the No Child Left Behind Act of 2001. As part of this evaluation, we are contacting
your organization to gather information about the SES you provide to students in [NAME OF
DISTRICT]. Both your state Department of Education and your school district are participating in
this study, and they encourage your participation.
The enclosed questionnaire should take about 30 minutes to complete. All of your answers
should focus only on the services provided to students from [NAME OF DISTRICT] for the 20082009 school year. Participation in this survey is voluntary. We hope you will answer as many
questions as you can. Information from your organization is essential in order to provide a
comprehensive picture of SES being implemented in districts across the U.S. You will receive a
check for $30 for completing the questionnaire. Please complete the enclosed check request form to
indicate where the check should be sent, and return it with your completed questionnaire.
Your responses to this data collection are protected from disclosure per the policies and
procedures required by the Education Sciences Reform Act of 2002, Title I, Part E, Section 183.
Responses to this data collection will be used only for statistical purposes. Mathematica Policy
Research (MPR) will present the information collected as part of this survey in an aggregate form,
and will not associate responses to any of the individual SES providers who participate. MPR will
not provide information that identifies you and your organization to anyone outside the study team,
except as required by law. Any willful disclosure of such information for nonstatistical purposes,
without the informed consent of the respondent, is a class E felony.
By participating, you will be making a contribution to a study that will inform district
officials, policymakers, and parents about the supplemental services available under NCLB. You are
welcome to discuss your participation in the study in your informational materials.
Please feel free to consult with your colleagues if you are unsure about the answers to some
of the questions. If you have questions about the study, please contact Karen Bogen, the MPR Survey
Director. She can be reached at 617-674-8355 or at [email protected]. Thank you in
advance for your assistance with this important study.
Sincerely,

Yumiko Sekino
Project Officer

555 NEW JERSEY AVE., NW, WASHINGTON, D.C. 20208

Bridgeport Public Schools
2008 – 2009
CITY HALL

KATHLEEN H. FLYNN

45 Lyon Terr. – Room # 306
Bridgeport, Connecticut 06604
Telephone (203) 275-1018/ 275-1019 Fax (203) 337-0160

Priority District Grant Manager
[email protected]

June 2009

Dear SES Provider:
The U.S. Department of Education (ED) has asked our district to participate in a study to evaluate the impact on student
achievement of Supplemental Educational Services (SES). The Bridgeport Public School District is working closely
with Mathematica Policy Research, Inc. (MPR), the organization contracted by the Department of Education to conduct
the study. As part of this evaluation, MPR is contacting SES providers to gather information about the SES you provide
to our students.
I would like to encourage you to participate in the study by completing the enclosed questionnaire. Participation in this
survey is voluntary. We hope you will answer as many questions as you can. You will receive a check for $30 from
MPR for completing the questionnaire. Please complete the enclosed check request form to indicate where the check
should be sent, and return it with your completed questionnaire.
Your responses to this data collection are protected from disclosure per the policies and procedures required by the
Education Sciences Reform Act of 2002, Title I, Part E, Section 183. Responses to this data collection will be used only
for statistical purposes. Mathematica Policy Research (MPR) will present the information collected as part of this
survey in an aggregate form, and will not associate responses to any of the individual SES providers who participate.
MPR will not provide information that identifies you and your organization to anyone outside the study team, except as
required by law. Any willful disclosure of such information for nonstatistical purposes, without the informed consent of
the respondent, is a class E felony.
Not only will your participation inform policymakers and parents about supplemental services, it will also help our
district get a clearer picture of the services being provided to our students and the characteristics of the organizations
serving them. If it will be useful or beneficial to your organization, you can discuss your participation in this study.
If you have questions about the study, please contact Karen Bogen, the MPR Survey Director. She can be reached at
617-674-8355 or at [email protected].
Thanks for being a member of our SES team and helping out with this important study.
Sincerely,

District SES Coordinator


File Typeapplication/pdf
File TitleSES Provider Survey
SubjectQuestionnaire
AuthorLaura Kalb, Jennifer McGovern
File Modified2009-06-04
File Created2009-06-04

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