NHES Nonresponse Screener

U.S. Department of Education

National Household Education Survey National Center for Education Statistics

S tart Here

► We recently mailed you a survey but did not receive your response. It is important that we hear from all households. Please have an adult living at this address complete this short form so your household can be included in our study.

► Please use blue or black pen if available.

1. How many years have you lived at this address?

Write “0” if less than 1 year.

|__|__| years at this address

2. Is this house …

Mark [X] ONE only.

• Owned or being bought by someone in this household,

• Rented by someone in this household, or

• Occupied by some other arrangement?

3. Are there any adults in this household who do not read English well?

• Yes

• No

4. Are there any adults in this household who do not speak English at home?

• Yes

• No

5. What is the highest grade or level of school completed among the adults in this household?

Mark [X] ONE only.

• 8^th grade or less

• Some high school, but did not graduate

• High school graduate or GED

• Some college or associate’s degree

• Four year college degree (BA or BS)

• Some graduate or professional education but no degree

• Graduate or professional degree beyond a bachelor’s degree

6. How many persons age 21 or older live at this address?

|__|__| number age 21 or older

7. How many persons age 20 or younger live at this address?

Do not include those living in college housing.

|__|__| number age 20 or younger

8. Is there at least one telephone inside this home that is currently working and not a cell phone?

• Yes

• No

9. Do you or anyone in this household have a working cell phone?

• Yes

• No

► Thank you. Please fold to display the postage paid return address and place in the mail.

For questions regarding this survey call toll-free 1-888-880-3033.

Project: 86420104

The National Center for Education Statistics is authorized to conduct this survey under Section 9543, 20 US Code. Your participation is voluntary. Your answers may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required by law (Section 9573, 20 US Code). The information you provide will be combined with information from other participants to produce statistical summaries and reports.

On average, it should take 1 minute for you to respond, including the time for reviewing instructions, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Andrew Zukerberg National Center for Education Statistics, U.S. Department of Education, 1990 K Street NW, Room 9036, Washington, DC 20006-5650. Do not return the completed form to this address.