59 Education Proxy Report for Children

Attachment 59

Education Proxy Report for Children

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX

Education Proxy Report for Children
Estimated time burden: 2 minutes
Item Stem

Responses

Responses2

Now we have some questions about the
education level of your child you
brought in for testing.1
At ANY TIME IN THE LAST 3 months has
your child attended high school or
college?

1=No, my child has not attended in the
last 3 months
2=Yes, my child is a full-time student
3=Yes, my child is a part-time student

What is the highest grade or level of
school your child has completed or the
highest degree your child has received?
If currently enrolled, mark the previous
grade or highest degree received.

00=No formal schooling
21=Preschool
22=Kindergarten
01=1st grade
02=2nd grade
03=3rd grade
04=4th grade
05=5th grade
06=6th grade
07=7th grade
08=8th grade
09=9th grade
10=10th grade
11=11th grade
12=12th grade - No diploma
13=High School Diploma, GED, or
alternative credential

Associate’s degrees (AA’s) can have an
occupational, technical, or vocational
focus or an academic focus.
Occupational, technical, or vocational
AA’s are awarded in fields such as
nursing and consumer services and
typically provide training for specific
jobs. Academic AA’s are primarily
awarded in liberal arts and the sciences
and are typically sought by students
who intend to transfer into a bachelor’s
degree program. Would you say your
child's AA degree was…?

0=Occupational, technical or
vocational
1=Academic

14=Some college credit but less that
1 year of college credit
15=1 or more years of college, no
degree
16=Associates degree (for example,
AA, AS)
17=Bachelor’s degree (for example:
BA, AB, BS)

Public reporting burden for this collection of information is estimated to average 2 1/2 hours per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (0925-xxxx*) EXP: (xx/xxxx). Do not return the completed form to this address.

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX
Item Stem

Responses

Not including the credits earned for the
associate’s degree, how many
additional years of college credits has
your child completed toward a
bachelor’s degree?

0=No additional credits or less than
one year of additional credits
completed toward a bachelor's degree
1=1 year of credits completed toward
a bachelor's degree
2=2 years of credits completed toward
a bachelor's degree
3=3 or more years of credits
completed toward a bachelor's degree

Which does your child have, a high
school diploma, a GED, or an
alternative credential?

0=High School Diploma
1=GED
2=Alternative credential

Please specify alternative credential. If
unknown, enter unknown:
What was the highest grade in school
that your child successfully passed?

00=No formal schooling
01=1st grade
02=2nd grade
03=3rd grade
04=4th grade
05=5th grade
06=6th grade
07=7th grade
08=8th grade
09=9th grade
10=10th grade
11=11th grade
12=12th grade - No diploma

Which best describes the amount of
college credit your child has
successfully completed toward a
bachelor’s degree?

1=1 year of credits earned toward a
bachelor’s degree
2=2 years of credits earned toward a
bachelor’s degree
3=3 or more years of credits earned
toward a bachelor’s degree

Responses2