Student Records Data Collection

APPENDIX E

STUDENT RECORDS DATA COLLECTION

1. Cover Letter

2. Instructions for Providing Student Records

STUDENT RECORDS DATA REQUEST

Dear [DISTRICT CONTACT]:

We would like to thank your district for participating in the national Evaluation of the Teacher Incentive Fund (TIF) conducted in prior years by Mathematica Policy Research for the U.S. Department of Education. This study will produce valuable information on the impact of performance-based incentive programs on student achievement and educator mobility and retention.

We greatly appreciate your assistance with this important study.

As part of the study, we are collecting information from district records for the students in the study. I am writing to request that your district provide us with data for each student in tested grades in the study schools. Please note that you are obligated to respond as required to obtain or retain a benefit (Office of Elementary and Secondary Education: Overview Information; Teacher Incentive Fund: Notice Inviting Applications for New Awards for Fiscal Year (FY) 2010, 75 FR 28740-28749 (May 21, 2010)).

The attached table indicates the specific items that we are requesting for the current school year. Also attached are instructions for returning the data to us. You can choose among three ways to return the data: (1) posting the files to our secure website; (2) emailing the password-protected files; or (3) sending the hard copy lists via Federal Express.

Thank you very much for your assistance with this data request. A member of our study team will contact you in the next week to determine if you have any questions about this request. You can reach me at (xxx) xxx-xxxx or xxxxxxxxxxxxxxxxx.

Sincerely,

xxxxxxxxxxxxxxxxxxxxxxxxxxx

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 1850-0876. The time required to complete this information collection is estimated to average 8 hours per year, including the time to review instructions, gather the data needed, and complete and review the information collection. (Office of Elementary and Secondary Education: Overview Information; Teacher Incentive Fund: Notice Inviting Applications for New Awards for Fiscal Year (FY) 2010, 75 FR 28740-28749 (May 21, 2010)). ). If you have any comments or concerns regarding the status of your individual submission of this survey, please contact (U.S. Department of Education, Institute of Education Sciences, 555 New Jersey Ave, NW, Washington, DC 20208) directly. (Note: Please do not return the completed survey to this address).

Item #	Data Item
Student’s Background and Demographic Information
1	Last and first name
2	Sex
3	District ID number
4	Date of birth (mm/dd/yy)
5	Ethnicity (Hispanic or Latino origin)
6	Race
Year-Specific Information (2014–2015)
7	School Name
8	School ID
9	Days Enrolled
10	Student’s grade level
11	Free- or reduced-price school lunch status
12	English Language Learner (ELL) status
13	Special education/IEP status
14	Type of disability, if any
15	504 Plan status
Test Scores (Spring 2015 and Spring 2014)
16	Math test information Name of test, publisher, grade level administered. If alternative assessment, please indicate.
17	Math scale score Scale score from math section of state or district test. Scale score is preferred, but normal curve equivalents, percentile ranks, or number correct are acceptable (in descending order of preference).
18	Reading test information Name of test, publisher, grade level administered. If alternative assessment, indicate this.
19	Reading scale score Scale score from math section of state or district test. Scale score is preferred, but normal curve equivalents, percentile ranks, or number correct are acceptable (in descending order of preference).
Attendance and Promotion Information (2014-2015)
20	Promotion status Indicate whether the student was promoted to a higher grade as of May/June prior to the start of the school year.
21	Number of days absent from school
22	Disciplinary record Information on suspensions or other disciplinary action
Teacher Information (2014-2015)
Student’s Reading, Language Arts, or English teacher
23	Last name of teacher
24	First name of teacher
25	District ID of teacher
Student’s Math teacher
26	Last name of teacher
27	First name of teacher
28	District ID of teacher

Notice of Confidentiality

Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific district or individual. We will not provide information that identifies you or your district to anyone outside the study team, except as required by law. Additionally, no one at your school or in your district will see your responses. Participation or cooperation with this activity is a condition of your grant (EDGAR: part 75.591, Authority: 20 U.S.C. 1221e–3 and 3474).

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time required to complete this information collection is estimated to average 8 hours per year, including the time to review instructions, gather the data needed, and complete and review the information collected. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 20202. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: U.S. Department of Education, Institute of Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208.