WWC Evaluator Registration

What Works Clearinghouse

Form06_EvaluatorRegistration_rev

WWC Evaluator Registration

OMB: 1850-0788

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Thank you for choosing to submit your registration information to the What Works Clearinghouse Registry of Outcome Evaluators. Potential sponsors and users of evaluation studies that seek evidence of effectiveness about educational interventions will search this Registry in order to access information about individual and organizational providers who have outcome evaluation experience and who commit to standards of evidence established by the What Works Clearinghouse. We encourage you to review these standards before completing and submitting a registration form for inclusion in this Registry. If your registration form is complete, we will provide you with a letter of commitment and permission (pdf) that you must read and to which you must agree before your information will be searchable from the public site.

We encourage you to print a
paper copy of this form in order to review all of the required information before completing the online registration form. If you have questions about filling out this form, or prefer to submit this information in paper form, please contact us at:

What Works Clearinghouse
2277 Research Boulevard, MS 6M
Rockville, MD 20850
Email:
[email protected]
Phone: 1-866-WWC-9799
Fax: 301-519-6760

 

Please indicate if you are submitting a registration form to be considered for inclusion in the Registry of Outcome Evaluators as an individual or for an organization that employs two or more staff members who provide evaluation-related services:
 

    1. Individual Evaluator    2. Organization

 

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1850–0788. The time required to complete this information collection is estimated to average 120 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 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, D.C. 20202–4700. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Susan Sanchez, U.S. Department of Education, Institute of Education Sciences, Room 500G, 555 New Jersey Avenue, NW, Washington, DC, Washington, D.C. 20208.

The information in the Registry of Outcome Evaluators is supplied solely by the evaluators themselves. Neither the What Works Clearinghouse (WWC) nor the U.S. Department of Education endorses any individuals or organizations listed in the Registry. The WWC does not verify the accuracy of the information submitted by the evaluators nor does it assess their qualifications.


INDIVIDUAL EVALUATOR DATA COLLECTION FORM

1. Evaluator Name: _______________________________________________________________

Title: ____________________________________________________________________________

Organization 1 (if applicable): ________________________________________________________

Organization 2 (if applicable): __________________________________________________________

Address 1: ____________________________________________________________________________

Address 2: ____________________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: ___________________________

Country: _______________________________________________________________________________

Phone: ( ) - Fax: ( ) - E-mail: _______________________________

URL: http://____________________________________________________________________________



2. Indicate the number of years of experience you have had with each type of evaluation service below.

Evaluation Services

Number of years of experience

Studies of Causal Inference

Experimental designs1

Quasi-experimental designs2


1 Experimental designs: Randomly assign individuals to groups

2 Quasi-experimental designs: Allow individuals to self-select into groups or put them into groups on the basis of a characteristic related to the outcome variable but using matching or statistical procedures to equate treatment and control groups, such as regression discontinuity, interrupted time series, and econometric models, among others



3. What is the geographic availability of your evaluation service? (Select all that apply)

National

Regional:

  1. 􀂉All

  2. 􀂉Great Lakes/Midwest

  3. 􀂉North Central

  4. 􀂉Northwest

  5. 􀂉Southeast

  6. 􀂉South Central

  7. 􀂉Southwest

  8. 􀂉Other (please specify): ________________


State or Foreign State/Province

Local: Specify _________________________



4. List up to three (3) projects under each of the two (2) study types below (up to six (6) projects total) with which you have evaluation experience.

Study Type:


Experimental Design

Quasi-experimental Design


Project Name: _________________________________________________________________

Populations included in study: ______________________________________________________

Outcomes measured: _____________________________________________________________

Start date: MM/DD/YYYY End Date: MM/DD/YYYY

Sponsoring Organization: __________________________________________________________

Sponsor Contact Name: ___________________________________________________________

Address 1: ______________________________________________________________________

Address 2: ______________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: _________________

Country: _______________________________________________________________________

Phone: ( ) - Fax: (___)____-_________ E-mail: ___________________



Check here if confidentiality provisions prevent you from including a full listing of examples and you would like potential sponsors and/or users of evaluation studies to contact you for further information regarding relevant studies you have conducted.



5. Indicate the content area(s) that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)


  1. 􀂉Adult Basic Education (ABE)

  2. 􀂉Adult Literacy

  3. 􀂉Algebra

  4. 􀂉Arithmetic

  5. 􀂉Arts

  6. 􀂉Beginning Reading

  7. 􀂉Bilingual Education

  8. 􀂉Biology

  9. 􀂉Botany

  10. 􀂉Calculus

  11. 􀂉Career Education

  12. 􀂉Character Education

  13. 􀂉Chemistry

  14. 􀂉Civics

  15. 􀂉Computer Science

  16. 􀂉Earth Science

  17. 􀂉Economics

  18. 􀂉English

  19. 􀂉English (Second Language)

  20. 􀂉Environmental Education

  21. 􀂉Fine Arts

  22. 􀂉Fluency

  23. 􀂉Foreign Languages

  24. 􀂉General Educational Development (GED)

  25. 􀂉Geography

  26. 􀂉Geology

  27. 􀂉Geometry

  28. 􀂉Government

  29. 􀂉Graphic Arts

  30. 􀂉Health

  31. 􀂉History

  32. 􀂉Humanities

  33. 􀂉Language Arts

  34. 􀂉Limited English Speaking

  35. 􀂉Listening

  36. 􀂉Literature

  37. 􀂉Mathematics

  38. 􀂉Music

  39. 􀂉Natural Science

  40. 􀂉Phonemic Awareness

  41. 􀂉Phonics

  42. 􀂉Physical Education

  43. 􀂉Physics

  44. 􀂉Probability

  45. 􀂉Psychology

  46. 􀂉Reading

  47. 􀂉Reading Comprehension

  48. 􀂉Reading Strategies

  49. 􀂉Science

  50. 􀂉Second Languages

  51. 􀂉Social Studies

  52. 􀂉Sociology

  53. 􀂉Speech Communication

  54. 􀂉Statistics

  55. 􀂉Technology

  56. 􀂉Theater Arts

  57. 􀂉Trigonometry

  58. 􀂉Visual Arts

  59. 􀂉Vocational Education

  60. 􀂉Writing (Composition)

  61. 􀂉Other (Specify): __________


  1. 􀂉Not Applicable



6. Indicate other characteristics that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)


  1. 􀂉Ability Grouping

  2. 􀂉Accountability

  3. 􀂉Advanced Placement

  4. 􀂉After School Programs

  5. 􀂉Alternative Teacher Certification

  6. 􀂉Attendance

  7. 􀂉Behavior Problems

  8. 􀂉Class Size

  9. 􀂉Classroom Techniques

  10. 􀂉Compensatory Education

  11. 􀂉Comprehensive School Reform

  12. 􀂉Computer Assisted Instruction

  13. 􀂉Computer Uses in Education

  14. 􀂉Crime Prevention

  15. 􀂉Curriculum

  16. 􀂉Distance Education

  17. 􀂉Dropout Prevention

  18. 􀂉Educational Technology

  19. 􀂉Extended School Year

  20. 􀂉Grouping (Instructional Purposes)

  21. 􀂉High School Equivalency Programs

  22. 􀂉Individualized Education Programs

  23. 􀂉Instructional Materials

  24. 􀂉Lifelong Learning

  25. 􀂉Parent Participation

  26. 􀂉Preservice Teacher Education

  27. 􀂉Professional Development

  28. 􀂉Scheduling

  29. 􀂉School Choice

  30. 􀂉School Readiness

  31. 􀂉School Size

  32. 􀂉Socialization

  33. 􀂉Student Behavior

  34. 􀂉Student Motivation

  35. 􀂉Substance Abuse Prevention

  36. 􀂉Summer School

  37. 􀂉Teacher Education

  38. 􀂉Teacher Effectiveness

  39. 􀂉Teacher Training

  40. 􀂉Technology

  41. 􀂉Textbooks

  42. 􀂉Transportation

  43. 􀂉Truancy Prevention

  44. 􀂉Year Round Schools

  45. 􀂉Other (Specify): __________________


  1. 􀂉Not Applicable


7. Indicate the target population(s) that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)


Student Gender

  1. 􀂉Female Students

  2. 􀂉Male Students






Student Race/Ethnicity

  1. 􀂉American Indian or Alaska Native

  2. 􀂉Asian

  3. 􀂉Black or African American

  4. 􀂉Hispanic or Latino

  5. 􀂉Native Hawaiian or Other Pacific Islander

  6. 􀂉White


Student Level(s) of Education:

  1. 􀂉Preschool

  2. 􀂉Kindergarten

  3. 􀂉Elementary School

  4. 􀂉Middle School

  5. 􀂉High School

  6. 􀂉Postsecondary Education

  7. 􀂉Vocational/Career Education

  8. 􀂉Adult/Continuing Education


Student Disability

  1. 􀂉Developmentally Disabled Students

  2. 􀂉Emotionally Disabled Students

  3. 􀂉Hearing-Impaired Students

  4. 􀂉Learning Disabled Students

  5. 􀂉Physically Disabled Students

  6. 􀂉Students with Multiple Disabilities

  7. 􀂉Vision-Impaired Students

  8. 􀂉Speech-Impaired Students


Student Language

  1. 􀂉Limited English Proficient


Student Risk/Disadvantage

  1. 􀂉At Risk/Disadvantaged Students

  1. 􀂉Other (Specify): ________________

  1. 􀂉Not Applicable


Urbanicity

Rural □ Suburban □ Urban □ Not Applicable



8. What type(s) of degrees(s) have you earned? (Select all that apply.)


Discipline or Field

BA/BS

Masters

Doctorate

Computer Science/IT

Economics

Education

Mathematics

Public Policy

Psychology

Psychometrics

Sociology

Statistics

Other


9. List up to five (5) relevant reports or publications that best illustrate your evaluation experience.

Resource Type:

Published/Unpublished Report □ Book/Thesis □ Chapter in a Book □ Journal Article


Report Title: _____________________________________________________________

Author(s): ____________________________________________________________________

Year: _______ Publisher (if applicable): __________________________________________

URL: http://____________________________________________________________________


Book/Thesis Title: _____________________________________________________________

Author(s): ____________________________________________________________________

Year: _______ Publisher (if applicable): _______________________________

URL: http://____________________________________________________________________


Chapter Title: __________________________________________________________________

Book Title: _____________________________________________________________

Author(s): _____________________________________________________________________

Publication Year: _______ Publisher: ____________________________________________

Page number: _______

URL: http://____________________________________________________________________


Journal Article Title: ____________________________________________________________

Journal Title: __________________________________________________________________

Journal Volume/Issue Number (if applicable): ________________________________________

Page number: _______

Publication Date: ___________________________

URL: http://____________________________________________________________________


If study is not published, click here to submit an electronic copy of the study description or report.

URL: http://___________________________________________________________________


Check here if confidentiality provisions prevent you from including a full listing of examples and you would like potential sponsors and/or users of evaluation studies to contact you for further information regarding relevant evaluation publications you have authored.

ORGANIZATION EVALUATOR DATA COLLECTION FORM

1. Contact Name: ________________________________________________________________________

Title: ___________________________________________________________________

Organization 1: _________________________________________________________________________

Organization 2: _________________________________________________________________________

Address 1: ______________________________________________________________________________

Address 2: ______________________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: ________________________

Country: _______________________________________________________________________________

Phone: ( ) - Fax: (___)_____________ E-mail: _________________________

URL: http://_____________________________________________________________________________



2. List below the total number of professional staff in your organization who fall into each category of years of experience.

Evaluation Services

Number of Staff with Experience by Number of Years Experience

1 to 5

Years

6 to 9

Years

10 to 19 Years

20 or more Years

Studies of Causal Inference

Experimental designs1

Quasi-experimental designs2


1 Experimental designs: Randomly assign individuals to groups

2 Quasi-experimental designs: Allow individuals to self-select into groups or put them into groups on the basis of a characteristic related to the outcome variable but using matching or statistical procedures to equate treatment and control groups, such as regression discontinuity, interrupted time series, and econometric models, among others.



3. What is the geographic availability of your evaluation service? (Select all that apply)

National

Regional:

  1. 􀂉All

  2. 􀂉Great Lakes/Midwest

  3. 􀂉North Central

  4. 􀂉Northwest

  5. 􀂉Southeast

  6. 􀂉South Central

  7. 􀂉Southwest

  8. 􀂉Other (please specify): ________________


State or Foreign State/Province

Local: Specify _________________________



4. List up to seven (7) projects under each of the two (2) study types below (up to fourteen (14) projects total) with which your organization has experience.

Study Type

Experimental Design

Quasi-experimental Design


Project Name: _________________________________________________________________

Populations included in study: ______________________________________________________

Outcomes measured: _____________________________________________________________

Start date: MM/DD/YYYY End Date: MM/DD/YYYY

Sponsoring Organization: __________________________________________________________

Sponsor Contact Name: ___________________________________________________________

Address 1: ______________________________________________________________________

Address 2: ______________________________________________________________________

City: _________________________ State: Drop down ▼ Zip: _________________

Country: _______________________________________________________________________

Phone: ( ) - Fax: (___)____-_________ E-mail: ___________________



5. Indicate the content area(s) that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)


  1. 􀂉Adult Basic Education (ABE)

  2. 􀂉Adult Literacy

  3. 􀂉Algebra

  4. 􀂉Arithmetic

  5. 􀂉Arts

  6. 􀂉Beginning Reading

  7. 􀂉Bilingual Education

  8. 􀂉Biology

  9. 􀂉Botany

  10. 􀂉Calculus

  11. 􀂉Career Education

  12. 􀂉Character Education

  13. 􀂉Chemistry

  14. 􀂉Civics

  15. 􀂉Computer Science

  16. 􀂉Earth Science

  17. 􀂉Economics

  18. 􀂉English

  19. 􀂉English (Second Language)

  20. 􀂉Environmental Education

  21. 􀂉Fine Arts

  22. 􀂉Fluency

  23. 􀂉Foreign Languages

  24. 􀂉General Educational Development (GED)

  25. 􀂉Geography

  26. 􀂉Geology

  27. 􀂉Geometry

  28. 􀂉Government

  29. 􀂉Graphic Arts

  30. 􀂉Health

  31. 􀂉History

  32. 􀂉Humanities

  33. 􀂉Language Arts

  34. 􀂉Limited English Speaking

  35. 􀂉Listening

  36. 􀂉Literature

  37. 􀂉Mathematics

  38. 􀂉Music

  39. 􀂉Natural Science

  40. 􀂉Phonemic Awareness

  41. 􀂉Phonics

  42. 􀂉Physical Education

  43. 􀂉Physics

  44. 􀂉Probability

  45. 􀂉Psychology

  46. 􀂉Reading

  47. 􀂉Reading Comprehension

  48. 􀂉Reading Strategies

  49. 􀂉Science

  50. 􀂉Second Languages

  51. 􀂉Social Studies

  52. 􀂉Sociology

  53. 􀂉Speech Communication

  54. 􀂉Statistics

  55. 􀂉Technology

  56. 􀂉Theater Arts

  57. 􀂉Trigonometry

  58. 􀂉Visual Arts

  59. 􀂉Vocational Education

  60. 􀂉Writing (Composition)

  61. 􀂉Other (Specify): __________


  1. 􀂉Not Applicable



6. Indicate other characteristics that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)


  1. 􀂉Ability Grouping

  2. 􀂉Accountability

  3. 􀂉Advanced Placement

  4. 􀂉After School Programs

  5. 􀂉Alternative Teacher Certification

  6. 􀂉Attendance

  7. 􀂉Behavior Problems

  8. 􀂉Class Size

  9. 􀂉Classroom Techniques

  10. 􀂉Compensatory Education

  11. 􀂉Comprehensive School Reform

  12. 􀂉Computer Assisted Instruction

  13. 􀂉Computer Uses in Education

  14. 􀂉Crime Prevention

  15. 􀂉Curriculum

  16. 􀂉Distance Education

  17. 􀂉Dropout Prevention

  18. 􀂉Educational Technology

  19. 􀂉Extended School Year

  20. 􀂉Grouping (Instructional Purposes)

  21. 􀂉High School Equivalency Programs

  22. 􀂉Individualized Education Programs

  23. 􀂉Instructional Materials

  24. 􀂉Lifelong Learning

  25. 􀂉Parent Participation

  26. 􀂉Preservice Teacher Education

  27. 􀂉Professional Development

  28. 􀂉Scheduling

  29. 􀂉School Choice

  30. 􀂉School Readiness

  31. 􀂉School Size

  32. 􀂉Socialization

  33. 􀂉Student Behavior

  34. 􀂉Student Motivation

  35. 􀂉Substance Abuse Prevention

  36. 􀂉Summer School

  37. 􀂉Teacher Education

  38. 􀂉Teacher Effectiveness

  39. 􀂉Teacher Training

  40. 􀂉Technology

  41. 􀂉Textbooks

  42. 􀂉Transportation

  43. 􀂉Truancy Prevention

  44. 􀂉Year Round Schools

  45. 􀂉Other (Specify): __________________


  1. 􀂉Not Applicable



7. Indicate the target population(s) that have been the focus of your evaluation experience. (Select all that apply or “Not Applicable.”)


Student Gender

  1. 􀂉Female Students

  2. 􀂉Male Students


Student Race/Ethnicity

  1. 􀂉American Indian or Alaska Native

  2. 􀂉Asian

  3. 􀂉Black or African American

  4. 􀂉Hispanic or Latino

  5. 􀂉Native Hawaiian or Other Pacific Islander

  6. 􀂉White



Student Level(s) of Education:

  1. 􀂉Preschool

  2. 􀂉Kindergarten

  3. 􀂉Elementary School

  4. 􀂉Middle School

  5. 􀂉High School

  6. 􀂉Postsecondary Education

  7. 􀂉Vocational/Career Education

  8. 􀂉Adult/Continuing Education


Student Disability

  1. 􀂉Developmentally Disabled Students

  2. 􀂉Emotionally Disabled Students

  3. 􀂉Hearing-Impaired Students

  4. 􀂉Learning Disabled Students

  5. 􀂉Physically Disabled Students

  6. 􀂉Students with Multiple Disabilities

  7. 􀂉Vision-Impaired Students

  8. 􀂉Speech-Impaired Students


Student Language

  1. 􀂉Limited English Proficient


Student Risk/Disadvantage

  1. 􀂉At Risk/Disadvantaged Students


Other (Specify): ________________

  1. 􀀀 Not Applicable


Urbanicity

Rural □ Suburban □ Urban □ Not Applicable



8. Number of professional staff in your organization: __________



9. Indicate the types of earned degrees held by your organization’s professional staff.


Discipline or Field

BA/BS

Masters

Doctorate

Computer Science/IT

Economics

Education

Mathematics

Public Policy

Psychology

Psychometrics

Sociology

Statistics

Other


10. List up to five (5) relevant reports or publications that best illustrate your organization’s evaluation experience.

Resource Type:


Published/Unpublished Report □ Book/Thesis □ Chapter in a Book □ Journal Article


Report Title: _____________________________________________________________

Author(s): ____________________________________________________________________

Year: _______ Publisher (if applicable): __________________________________________

URL: http://____________________________________________________________________


Book/Thesis Title: _____________________________________________________________

Author(s): ____________________________________________________________________

Year: _______ Publisher (if applicable): _______________________________

URL: http://____________________________________________________________________


Chapter Title: __________________________________________________________________

Book Title: _____________________________________________________________

Author(s): _____________________________________________________________________

Publication Year: _______ Publisher:__________________________________________

Page number: _______

URL: http://____________________________________________________________________


Journal Article Title: ____________________________________________________________

Journal Title: __________________________________________________________________

Journal Volume/Issue Number (if applicable): ________________________________________

Page number: _______

Publication Date: ___________________________

URL: http://____________________________________________________________________


If study is not published, click here to submit an electronic copy of the study description or report.

URL: http://___________________________________________________________________



Check here if confidentiality provisions prevent you from including a full listing of examples and you would like potential sponsors and/or users of evaluation studies to contact you for further information regarding relevant evaluation publications you have authored.


WHAT WORKS CLEARINGHOUSE REGISTRY OF OUTCOME EVALUATORS LETTER OF COMMITMENT



DATE


To: What Works Clearinghouse:


As part of (my/our) registration for listing in the Registry of Outcome Evaluators of the What Works Clearinghouse (WWC), (I/we) understand that the purpose of the registry is to provide a public listing to assist people in identifying those evaluators who have experience in conducting causal inference studies of the effectiveness of educational interventions. (I/We) commit to using the highest standards of scientific evidence, as defined by the WWC, for answering questions of the effectiveness of educational interventions. Further, (I/we) agree to make clear to sponsors and clients the degree to which the work (I/we) plan to conduct on their behalf will overcome or limit the threats to construct, internal, external and statistical validity and the resulting implications for making appropriate causal claims. I hereby submit (my/our) request for registration, and give you permission to use the information in the Registry of Outcome Evaluators and related WWC products. (I/We) further attest that the information provided herein is complete and accurate as of this date.


Sincerely,


File Typeapplication/msword
AuthorTeresa Duncan
Last Modified ByTeresa Duncan
File Modified2007-03-23
File Created2007-01-22

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