APPENDIX A1
Crosswalk of GK-12 Data Elements for the PI Survey
Data Elements of Graduate Teaching Fellows in K–12 Education (GK–12)
Distance Monitoring System
Question |
Staff and Project Participant Characteristics i |
Project Implementation Characteristicsii |
Project Outputs iii |
Section I. Data Entered by Principal Investigator |
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Award Information
NSF Award ID Grantee Institution Award Title Award Start Date Award End Date |
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X |
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Award Effort Information |
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X |
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Award Title |
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Effort Title |
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Associated Colleges and Universities |
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Schools |
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Award Evaluator |
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Award Discipline(s) Astronomy Behavioral Sciences Biological Sciences Chemistry Computer/Information Sciences Economic Science Engineering Environmental Science Geosciences Mathematics Physics/Physical Sciences Social Sciences Other |
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Other Award Discipline (only if you chose “Other” above) |
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Award Design Model Self-Contained Expository |
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Award Status Planning Recruiting Training Completed In Classroom |
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Award URL |
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Partner Organization(s) |
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Other Partner Organization’s Name (only if you chose “Other” above) |
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Additional Funding Source Information |
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X |
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Source Name |
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Additional Funding Source Type State Government Federal Government Local Government Home Institution Business Foundation Other |
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Other Source Type (only if you chose “Other” above) |
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Amount of Additional Funding |
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Associated Colleges and Universities Information |
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X |
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Institution Name |
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City |
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State |
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ZIP Code |
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FICE Code |
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School Information |
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X |
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School Name |
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School Level Elementary School Grades Middle School Grades High School Grades Prekindergarten or Kindergarten Through Middle School Middle School Through High School |
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State District Name |
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School Setting/Location Urban Suburban Rural |
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Start Date for School Involvement in Fellowship |
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End Date for School Involvement in Fellowship |
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Percentage of Eligible Students for Lunch Programs Not Applicable 1 – 10% 11 – 20% 21 – 30% 31 – 40% 41 – 50% 51 – 60% 61 – 70% 71 - 80% 81 – 90% 91 – 100% |
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Class Information |
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X |
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Class Name |
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Grade K – Kindergarten 1 – 1st Grade 2 – 2nd Grade 3 – 3rd Grade 4 – 4th Grade 5 – 5th Grade 6 – 6th Grade 7 – 7th Grade 8 – 8th Grade 9 – 9th Grade 10 – 10th Grade 11 – 11th Grade 12 – 12th Grade |
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Subject Mathematics – General Mathematics – Elementary School Mathematics – Middle School Mathematics – High School (Secondary) Science - Biology Science - Chemistry Science - Earth Science Science - Elementary Science Science - General Science Science - Integrated Science Science - Physical Science Science - Physics Art Computer Science English Foreign Language History/Social Studies Music Other |
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Other Subject (only if you chose “Other” above) |
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Number of Students |
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Participant Data (Award Evaluator Information) |
X |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Participant Data (Principal Investigator (PI)/Co-PI Information) |
X |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix Data Entry Privileges Primary status |
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Phone number |
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Phone extension |
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E-mail address |
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Participant Data (Co-PI Information) Co-PI/PI Title Co-PI/PI Academic Discipline Astronomy Behavioral Sciences Biological Sciences Chemistry Computer/Information Sciences Economic Science Engineering Environmental Science Geosciences Mathematics Physics/Physical Sciences Social Sciences Other Co-PI/PI Other Discipline (only if you chose “Other” above) Institution |
X |
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Participant Data (Graduate Fellow Information) |
X |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Social Security Number |
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Phone Number |
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Email Address |
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Fellowship Start Date Month Year |
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Fellowship End Date Month Year |
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Is this graduate fellow supported by NSF-GK-12 Funds? Yes No |
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X |
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Total Stipend Received By Graduate Fellow for participating in GK-12 fellowship Full 100% of $30,000 Partial 100% by other Other |
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X |
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Participant Data (Undergraduate Fellow Information) |
X |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Race (select one or more) American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander Not Reported White |
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Ethnicity Not Hispanic or Latino Hispanic or Latino Not Reported |
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Gender Male Female Not Reported
Citizenship |
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Disability Hearing Impairment Mobility or Orthopedic Impairment None Not Reported Other Visual Impairment |
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Other Disability (only if you chose “Other” above) |
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Undergraduate Fellow InformationHome Institution of Fellow Social Security Number Supported by NSF GK-12 funds Date of Birth Fellowship Start Date Fellowship End Date Fellow Discipline Astronomy Behavioral Sciences Biological Sciences Chemistry Computer/Information Sciences Economic Science Engineering Environmental Science Geosciences Mathematics Physics/Physical Sciences Social Sciences Other Fellow Academic Level During Fellowship Year Undergrad Junior Undergrad Senior Baccalaureate Degree
School Class |
X |
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Participant Data (Cooperating Teacher Information) |
X |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Phone Number |
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Phone Extension |
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E-mail Address |
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Participant Data (Other Participant Information) |
X |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Participant Description (check here for data entry staff) |
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Phone Number |
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Phone Extension |
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E-mail Address
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Achievements and Products Related to GK-12 Activities |
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Journal Articles In Refereed Publications |
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X |
Author(s) |
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Article Title |
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Publication Name |
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Volume |
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Number |
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Year |
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Pages |
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Journal Articles In Non-Refereed Publications |
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X |
Author(s) |
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Article Title |
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Publication Name |
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Volume |
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Number |
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Year |
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Pages |
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Books |
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X |
Author(s) |
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Book Title |
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Publisher |
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Year |
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ISBN# |
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Book Chapters |
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X |
Author(s) |
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Chapter Title |
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Book Title |
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Editor(s) |
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Publisher |
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Year |
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ISBN# |
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Curriculum/Module Development |
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X |
Author/Contributor |
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Title |
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Grade Band |
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Academic Disciplines Astronomy
Physics |
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Other (please specify) |
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Brief Description |
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Conference Publications |
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X |
Author(s) |
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Paper Title |
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Conference |
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Year |
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Pages |
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Conference Presentations |
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X |
Author(s) |
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Name of the Conference |
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Presentation Title |
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Date |
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Location |
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Organization |
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Other (Textbox) |
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Program outreach informationOutreach activities include your GK faculty and/or GK Trainees being featured on TV, radio, in magazine articles or otherwise in the media; talks, presentations, workshops given by GK-12 faculty, trainees and/or associates to school groups, civic groups, non-scientifically based professional groups, members of the government or the general public. Please separately list in the text box below the type of outreach activity, the organization/magazine/radio station/etc. for which the outreach was done, the location, who in your GK-12 did the outreach and date. |
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X |
i Elements of these characteristics include: Name, address, date of birth, gender, ethnicity, race, disability status, class, major, grade point average, yearly fellowship or stipend amount, or project role.
ii Elements of these characteristics include: Sources and amount of funds, fellowships, scholarships, traineeships, partnerships, training, research methods.
iii Elements of these characteristics include: research findings, publications, presentations, degrees granted, educational materials.
File Type | application/msword |
File Title | Common |
Author | mark morgan |
File Modified | 2007-10-01 |
File Created | 2007-10-01 |