High School and Beyond 2020 (HS&B:20) Base-Year Field Test Sampling and Recruitment

September High School and Beyond 2020 (HS&B:20)

Base-Year Field Test Sampling and Recruitment

OMB# 1850-new v.1

Supporting Statement Appendix B

Submitted by

National Center for Education Statistics

U.S. Department of Education

August 2018

Instructions: Please provide the information below for each student currently enrolled in the ninth and twelfth grades at your school. This information will be used to select an average of 35 ninth grade and 35 twelfth grade students from your school for the study.

General Student information

Race (Y/N all that apply)

Ethnicity (Y/N)

ELL

Parent Contact information

Student's Math Teacher

StudentID

FirstName

LastName

Suffix

Grade 9, Grade 12, or U=ungraded

Date of birth MM/DD/YY

Sex(M/F)

White

Black or African American

Asian

Native Hawaiian or Pacific Islander

American Indian or Alaska Native

Hispanic

Yes/No

Parent's First Name

Parent's Last Name

Parent's Address

Parent City

Parent State

Parent Zip

Parent's Email

Parent's Home Phone

Parent's Cell Phone

MathTeacherFirstName

MathTeacherLastName

MathTeacherEmail

Math Course Name

Math Course Period/Section

NCES is authorized to conduct the High School and Beyond 2020 (HS&B:20) by the Education Sciences Reform Act of 2002 (ESRA 2002, 20 U.S.C. §9543) and to collect students’ education records from education agencies or institutions for the purposes of evaluating federally supported education programs under the Family Educational Rights and Privacy Act (FERPA, 34 CFR §§ 99.31(a)(3)(iii) and 99.35). The data are being collected for NCES by RTI International, a U.S.-based nonprofit research organization. All of the information [respondent type] provide 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 (20 U.S.C. §9573 and 6 U.S.C. §151). The collected information will be combined across respondents to produce statistical reports.

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 voluntary information collection is 1850-XXXX. Approval expires XX/XX/20XX. The time required to complete this information collection is estimated to average approximately 5 minutes per row, including the time to review instructions, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate, suggestions for improving this information collection, or any comments or concerns regarding the status of your individual submission, please write directly to: The High School and Beyond 2020 (HS&B:20), National Center for Education Statistics, PCP, 550 12th St., SW, 4th floor, Washington, DC 20202.