Cognitive Interviews for the 2010 National Household Education Survey (NHES) Study Draft Questionnaires

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Cognitive Interviews for the 2010 National Household Education Survey (NHES) Study Draft Questionnaires

OMB: 1850-0803

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OMB No. 1850-0768

Commonly Asked Questions
Q:	 How did you get my address?
A:	 Your address was randomly selected from among all of the home addresses in the nation. It was selected using
scientific sampling methods to represent other households in the U.S.
Q:	 If there are no children or anyone currently in school in my household, should I respond?
A:	 Yes, you should respond to the short survey that was sent to your address. Once you return the questionnaire, the
study will be able to see if anyone in your household is eligible for the next and final survey. If no one is eligible you
will not receive another survey.

Approval Expires 08/31/2010

U.S. Department of Education
National Center for Education Statistics

National Household Education Survey

Q:	 Why don’t you ask more questions about education in this questionnaire?
A:	 The purpose of this questionnaire is to find out if anyone in your household is eligible for the next stage of the survey.
If so we will send a second questionnaire that will ask about educational experiences of a member of your household.
Q:	 Why should I take part in this study? Do I have to do this?
A:	 You represent thousands of other households like yours, and you cannot be replaced. Your answers and opinions
are very important to the success of this study. Your participation is voluntary. You may choose not to answer any
or all questions in this survey. There are no penalties should you choose not to participate in this study. In order for
the survey to be representative it is important that you complete and return this questionnaire.
Q:	 How will the information I provide be used?
A:	 Your responses will be combined with those of others to produce statistical summaries and reports. Your individual
data will not be reported. 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).
Q:	 How much time will it take?
A:	 On average, it should take 3 minutes 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.
Q:	 Who is sponsoring the study? Is this study conducted by the Federal Government?
A:	 The National Center for Education Statistics, within the Department of Education is authorized to conduct this study
(Section 9543, 20 US Code). Westat has been contracted to conduct this study. This study has been approved by
the Office of Management and Budget, the office that reviews all federally sponsored surveys. The approval number
assigned to this study is 1850-0768. You may send any comments about this survey, including its length, to the Federal
Government. Write to Andrew Zukerberg, National Center for Education Statistics, U.S. Department of Education, 1990
K Street NW, Room 9036, Washington, DC 20006-5650. You may send e-mail to [email protected].
Q:	 Who is Westat?
A:	 Westat is a research company located in Rockville, Maryland. Westat is conducting this survey under contract to the
U.S. Department of Education. If you have any questions about the study contact Westat toll-free at 1-888-880-3033.

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.

U.S. Department of Education

National Household Education Survey

National Center for Education Statistics

Start Here
The Department of Education is studying households
with youth or children age 20 or younger. Each
household is different and we need your response so
we can send you a survey that is right for your
household.
Return this form even if there are no youths or
children in this household after marking the
correct box in item 1.
This survey should be filled out by an adult
household member living at this address.

3. What is his or her first name,
initials, or nickname?..............

4. How old is this child in years?

Do not include those living in college housing.
Yes
No

5. What is this child's sex?........

6. Is this child currently in.........
Mark X ONE only.

GO TO box A at the bottom.

2. How many youth or children age 20 or
younger live in this household?
number age 20 or younger
Continue answering questions 3 through 7 for
each youth or child living in this household.
Start with the youngest youth or child who is
age 20 or younger.
A Thank you for your time, if you indicated in item 1
that no one living in your household is age 20 or
younger, please stop here and return the completed
questionnaire to us in the enclosed prepaid return
envelope. It is important that we receive a response
from every household selected for this study.

Youth / Child 2


Youth / Child 3


Youth / Child 4


Youth / Child 5


First name/initials/nickname

First name/initials/nickname

First name/initials/nickname

First name/initials/nickname

First name/initials/nickname

Mark for babies less
than 1 year old

Mark for babies less
than 1 year old

Mark for babies less
than 1 year old

Mark for babies less
than 1 year old

Mark for babies less
than 1 year old

age in years

Please use blue or black pen if available.
1. Are there any youth or children age 20 or
younger living in this household?

Youth / Child 1


7. What is this child's current
grade or equivalent?..............

age in years

age in years

age in years

age in years

Male

Male

Male

Male

Male

Female

Female

Female

Female

Female

Public or private school,
or preschool,

Public or private school,
or preschool,

Public or private school,
or preschool,

Public or private school,
or preschool,

Public or private school,
or preschool,

Homeschool instead of
school for some or all
classes, or

Homeschool instead of
school for some or all
classes, or

Homeschool instead of
school for some or all
classes, or

Homeschool instead of
school for some or all
classes, or

Homeschool instead of
school for some or all
classes, or

Not in school?
GO TO youth/child 2.

Not in school?
GO TO youth/child 3.

Not in school?
GO TO youth/child 4.

Not in school?
GO TO youth/child 5.

Not in school?
Return survey.

Preschool

Preschool

Preschool

Preschool

Preschool

Kindergarten

Kindergarten

Kindergarten

Kindergarten

Kindergarten

write grade
1 through 12

write grade
1 through 12

write grade
1 through 12

write grade
1 through 12

write grade
1 through 12

College or vocational
school

College or vocational
school

College or vocational
school

College or vocational
school

College or vocational
school

None of these

None of these

None of these

None of these

None of these

Thank you. Please return this form in the postage paid envelope provided or mail it to:
National Household Education Survey
Westat
1600 Research Blvd. Room TB146F
Rockville, MD 20850-9973
Toll-free number for questions: 1-888-880-3033
SCRNOUT


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