Study of Digital Learning Resources for Instructional English Learner Students

1875-NEW -Task4.4-Part 5-School Roster for Completion by Subsample District-toPPSS-2016-7-10

Study of Digital Learning Resources for Instructional English Learner Students

OMB: 1875-0279

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Task Order 27
Study of Digital Learning Resources for
Instructing English Learner Students
Task 4.4 (Part 5) School Roster for Completion by Subsample District

July 11, 2016

Submitted to:
U.S. Department of Education
Office of Planning, Evaluation and Policy Development

Submitted by:
Westat
1600 Research Boulevard
Rockville, Maryland 20850-3129
(301) 251-1500

Study of Digital Learning Resources for
Instructing English Learner Students
Task 4.4 (Part 5) School Roster for Completion by Subsample District

Prepared by:
Annette Zehler
Adrienne von Glatz
Karin Katterfeld
Jennifer Flynn
Eva Chen
Mihiri Silva
Westat
Philip Vahey
Savitha Moorthy
Daniela Torre
Kea Vogt
SRI International
Yesim Yilmazel-Sahin
OneWorld Linguistic Consulting, LLC
Michael Jay
Educational Systemics

Study of Digital Learning Resources (DLRs) for Instructing English Learner Students

School Roster: List of Schools in the District
Dear District Administrator,
Thank you for your participation in this important national Study of Digital Learning Resources (DLRs) for
Instructing English Learner Students. Your participation is voluntary, and your district’s contributions will
help to ensure that the findings accurately reflect the experience of districts across the country in using
DLRs for instruction of EL students.
The study requests the participation of one school from your district. We will select the school based on
this School Roster form, and will coordinate with the school to identify two teachers according to our
study requirements who will be asked to complete a teacher survey on their use of DLRs. All responses
will be protected to maintain confidentiality except as may be required by law.
In responding to this request, please do the following:
1) Confirm that this form is labeled correctly with your district name below.
2) Refer to the instruction sheet before completing the list of schools.
3) Review, update and complete the pre-filled list of schools:


Indicate the total number of K–12 schools in your district (Step 1)



Delete or cross-through schools that are no longer active in the current school year



Add new schools that are now active in the current school year



Indicate the total number of teachers (full-time and part-time) in each school, including any
itinerant teachers assigned to the school.



Indicate the number of English learner (EL) students enrolled in each school as of fall 2016.
If there are no EL students enrolled in a school, enter “0”.
*NOTE: Please be sure to indicate even one EL student or very small
numbers of EL students enrolled in a school. Approximately 70 percent of
districts in the U.S. have small numbers of EL students and it is important
to ensure that their perspectives are included in this study’s findings.

4) PLEASE RETURN THIS COMPLETED FORM TO: [email protected]
STUDY DISTRICT ID AND NAME OF SAMPLED DISTRICT HERE

Thank you. Please keep a copy of the completed list of schools for your records.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such a
collection 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 30 minutes per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any
comments concerning the accuracy of the time estimate or suggestions for improving the survey, please write: U.S. Department of
Education, Washington D.C. 20202-4651. If you have comments or concerns regarding the contents or the status of your individual
survey, write directly to: Study of Digital Learning Resources (DLRs) for Instructing EL Students, Policy and Program Studies Service, Office
of Planning, Evaluation and Policy Development, 400 Maryland Ave, SW, Washington DC 20202.

CONFIDENTIALITY
We will not present any personally identifiable information in any report or publication resulting from the study; we will not
identify your school or district in any study report or publication; and no responses will be linked with any identifying
information in any final data files created for the study. All responses will be aggregated and summarized across respondents.
The study team will protect or maintain the confidentiality of your responses except as may be required by law. No individuals
other than research staff will see any individually identifying data (for example, names or addresses). Your participation is
voluntary; however, your district’s participation is very important to providing policymakers with accurate and complete
information. Data collection is being conducted in only a sample of districts throughout the nation. This greatly increases the
importance of your response since it represents many other districts.
If you have any questions about the study, please call 855-241-7535. If you have questions about your rights as a study
participant, please call the Westat Human Subjects Protections office at 1-888-920-7631. Please leave a message with your full
name, the name of the study (Study of DLRs for Instructing English Learner Students), and a phone number beginning with the
area code. A research office staff person will return your call as soon as possible.

Study of Digital Learning Resources (DLRs) for Instructing English Learner Students
LIST OF SCHOOLS IN THE DISTRICT- INSTRUCTION SHEET

Please review the list of K–12 schools below in your district. Do not include schools
serving only pre-school students.
If any K–12 schools are missing, please add the school’s name.
If any K–12 schools have closed, please delete the school from the list.
Confirm that the total number of K–12 schools listed is accurate.
Please confirm that the correct grade levels are listed for each school.

For each of the schools on your list, please provide the total number of teachers serving at
that school.
Include both full-time and part-time teachers, and include any itinerant teachers
assigned to the school.

For each of the schools on your list, please provide the number of English Learner
students at that school.

DEFINITION:

English learner (EL) refers to students who are individuals not born in the United States or whose native
language is other than English, and individuals who come from non-English dominant environments,
whose skills in English are so limited that they derive little benefit from regular school instruction.
“English learner” also refers to students who have no proficiency in English. Note: If your district has an
operational definition for English learner students, then use your district’s definition in responding.
THANK YOU. PLEASE KEEP A COPY OF THE COMPLETED LIST OF SCHOOLS FOR YOUR RECORDS!

Study of Digital Learning Resources (DLRs) for Instructing English Learner Students

List of Schools in the District
District name:
District ID:
STEP 1: Please note the total number of schools in your district here: ___________
STEP 2: Please complete the list of schools below as indicated in the instructions.
NOTE: Please refer to the INSTRUCTION SHEET for important information before completing this form.
Grade levels taught by school

Number of
teachers

(if inaccurate, please correct)

K–12 schools within district
(if inaccurate, please correct)

Gr. Gr.
1
2

Gr.
3

Gr.
4

Gr.
5

Gr.
6

Gr.
7

Gr.
8

Gr.
9

Gr.
10

Gr. Gr.
11 12 Ungraded

(see
instructions)

Number of
English learner (EL)
students
(Specify “0” if none)

1. POPULATE NAMES AND GRADES PRIOR TO SENDING
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

Grade levels taught by school