NHES Screener Interviews

National Household Education Surveys Program (NHES: 2011/2012) Field Test

SCNR-Screen-out pilot

NHES Screener Interviews

OMB: 1850-0768

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OMB No. XXXX-XXXX: Approval Expires XX/XX/XXXX

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 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 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.

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National Household Education Survey

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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.


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Start Here National Household Education Survey



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.

Please use blue or black pen if available.

1. Are there any youth or children age 20 or younger living in this household?

Do not include those living in college housing.

  • YShape9 Shape8 es

  • NShape10 o 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 1

Youth / Child 2

Youth / Child 3

Youth / Child 4

Youth / Child 5


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









First name/initials/nickname









First name/initials/nickname









First name/initials/nickname









First name/initials/nickname









First name/initials/nickname









4. How old is this child in years?

  • Mark for babies less than 1 year old

|__|__| age in years

  • Mark for babies less than 1 year old

|__|__| age in years

  • Mark for babies less than 1 year old

|__|__| age in years

  • Mark for babies less than 1 year old

|__|__| age in years

  • Mark for babies less than 1 year old

|__|__| age in years









5. What is this child’s sex?

  • Male

  • Female

  • Male

  • Female

  • Male

  • Female

  • Male

  • Female

  • Male

  • Female









6. 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

  • Not in school?

GShape11 O TO youth/child 2.

  • Public or private school, or preschool,

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

  • Not in school?

GShape12 O TO youth/child 3.

  • Public or private school, or preschool,

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

  • Not in school?

GShape13 O TO youth/child 4.

  • Public or private school, or preschool,

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

  • Not in school?

GShape14 O TO youth/child 5.

  • Public or private school, or preschool,

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

  • Not in school?

Shape15 Return survey.









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

  • Preschool

  • Kindergarten

write

|__|__| grade 1 through 12

  • College or vocational school

  • None of these

  • Preschool

  • Kindergarten

write

|__|__| grade 1 through 12

  • College or vocational school

  • None of these


  • Preschool

  • Kindergarten

write

|__|__| grade 1 through 12

  • College or vocational school

  • None of these

  • Preschool

  • Kindergarten

write

|__|__| grade 1 through 12

  • College or vocational school

  • None of these

  • Preschool

  • Kindergarten

write

|__|__| grade 1 through 12

  • College or vocational school

  • 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 RC B16

Rockville, MD 20850-9973

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