NHES Core Item Screener

National Household Education Survey

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.

National Household Education Survey

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► This survey should be filled out by an adult household member living at this address.

► Please use a blue or black pen if available.

► The Department of Education is studying households with and without children. Answer the following questions about your household and the people who live there.

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 speak English at home?

• N o GO TO question 5.

• Y es

4. What language do they speak at home?

• Spanish

• Another language

S pecify: |_____________________|

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. What is the best phone number to reach you if we have more education questions about someone in your household?

(__|__|__) |__|__|__| – |__|__|__|__|

► For these next questions, please think about everyone who lives in this household.

7. How many females live in this household?

|__|__| number of females

8. How many males live in this household?

|__|__| number of males

9. Of everyone in this household, how many are age 20 or younger?

Do not include those living in college housing.

|__|__| number age 20 or younger

► If anyone age 20 or younger usually lives in this household, then fill in the rest of this survey. If no one in this household is age 20 or younger return this survey in the postage paid envelope that came with the survey.

YOUTH / CHILD 1

► Start with the youngest youth or child who is age 20 or younger.

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

|__|__|__|__|__|__|__|__|__|__|

First name / initials / nickname

2. How old is this child in years?

• Mark for babies less than 1 year old

|__|__| age in years

3. What is this child’s sex?

• Male

• Female

4. Is this child currently in …

Mark [X] ONE only.

• Public or private school, or preschool,

• Homeschool instead of school for some or all classes, or

• N ot in school? GO TO A AT BOTTOM

5. What is this child’s current grade or equivalent?

• Preschool

• Kindergarten

|__|__| write grade 1 through 12

• College or vocational school

• None of these

A. Continue with youth or child 2. If no one else age 20 or younger lives here return this form in the postage paid envelope provided.

YOUTH / CHILD 2

► Continue with the next youngest youth or child who is age 20 or younger.

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

|__|__|__|__|__|__|__|__|__|__|

First name / initials / nickname

2. How old is this child in years?

• Mark for babies less than 1 year old

|__|__| age in years

3. What is this child’s sex?

• Male

• Female

4. Is this child currently in …

Mark [X] ONE only.

• Public or private school, or preschool,

• Homeschool instead of school for some or all classes, or

• N ot in school? GO TO A AT BOTTOM

5. What is this child’s current grade or equivalent?

• Preschool

• Kindergarten

|__|__| write grade 1 through 12

• College or vocational school

• None of these

A. Continue with youth or child 3. If no one else age 20 or younger lives here return this form in the postage paid envelope provided.

► Youth/child 3 through 6 continue on the next pages.

YOUTH / CHILD 3

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

|__|__|__|__|__|__|__|__|__|__|

First name / initials / nickname

2. How old is this child in years?

• Mark for babies less than 1 year old

|__|__| age in years

3. What is this child’s sex?

• Male

• Female

4. Is this child currently in …

Mark [X] ONE only.

• Public or private school, or preschool,

• Homeschool instead of school for some or all classes, or

• N ot in school? GO TO A AT BOTTOM

5. What is this child’s current grade or equivalent?

• Preschool

• Kindergarten

|__|__| write grade 1 through 12

• College or vocational school

• None of these

A. Continue with youth or child 4. If no one else age 20 or younger lives here return this form in the postage paid envelope provided.

YOUTH / CHILD 4

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

|__|__|__|__|__|__|__|__|__|__|

First name / initials / nickname

2. How old is this child in years?

• Mark for babies less than 1 year old

|__|__| age in years

3. What is this child’s sex?

• Male

• Female

4. Is this child currently in …

Mark [X] ONE only.

• Public or private school, or preschool,

• Homeschool instead of school for some or all classes, or

• N ot in school? GO TO A AT BOTTOM

5. What is this child’s current grade or equivalent?

• Preschool

• Kindergarten

|__|__| write grade 1 through 12

• College or vocational school

• None of these

A. Continue with youth or child 5. If no one else age 20 or younger lives here return this form in the postage paid envelope provided.

YOUTH / CHILD 5

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

|__|__|__|__|__|__|__|__|__|__|

First name / initials / nickname

2. How old is this child in years?

• Mark for babies less than 1 year old

|__|__| age in years

3. What is this child’s sex?

• Male

• Female

4. Is this child currently in …

Mark [X] ONE only.

• Public or private school, or preschool,

• Homeschool instead of school for some or all classes, or

• N ot in school? GO TO A AT BOTTOM

5. What is this child’s current grade or equivalent?

• Preschool

• Kindergarten

|__|__| write grade 1 through 12

• College or vocational school

• None of these

A. Continue with youth or child 6. If no one else age 20 or younger lives here return this form in the postage paid envelope provided.

YOUTH / CHILD 6

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

|__|__|__|__|__|__|__|__|__|__|

First name / initials / nickname

2. How old is this child in years?

• Mark for babies less than 1 year old

|__|__| age in years

3. What is this child’s sex?

• Male

• Female

4. Is this child currently in …

Mark [X] ONE only.

• Public or private school, or preschool,

• Homeschool instead of school for some or all classes, or

• N ot in school? GO TO A AT BOTTOM

5. What is this child’s current grade or equivalent?

• Preschool

• Kindergarten

|__|__| write grade 1 through 12

• College or vocational school

• None of these

A. 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 TB135

Rockville, MD 20850-3129

Toll-free number for questions: 1-888-880-3033

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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.

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 5 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 XXXX-XXXX. 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.