Student Teaching Diversity Report SurveyMonkey

#121 COMPLETE
Collector: Web Link (Web Link)
Started: Monday, January 30, 2017 12:06:48 PM
Last Modified: Monday, January 30, 2017 12:09:48 PM
Time Spent: 00:02:59
IP Address: 204.126.11.207

PAGE 1: Student Teacher Information

Q1: Student Teacher Name: Caitlin Jennings

Q2: Please indicate on which of the following you are Student Teaching Placement 1
reporting information:

Q3: Semester and year in which you are reporting this Spring 2017
experience:

PAGE 2: Classroom Specifics

Q4: Description of the type of classroom (i.e. inclusive, gifted):

Inclusion Class

Q5: Grade of the students for which you are reporting Fourth Grade
information:

Q6: Number of students in the classroom: 34 (number in a.m. group 17/ number in p.m. group 17)

PAGE 3: Student Gender and Economic Status

Q7: Male students: 18

Q8: Female students: 16

Q9: Free/Reduced Lunch students: 100%

Q10: Not Free/Reduced Lunch students: 0

PAGE 4: Student Race/Ethnicity

Q11: American Indian or Alaskan Native: Respondent skipped this

question

Q12: Asian or Pacific Islander: Respondent skipped this

question

Q13: Black, non-Hispanic 25

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 Student Teaching Diversity Report SurveyMonkey

Q14: Hispanic: 2

Q15: Multiracial 1

Q16: Non-resident Alien: Respondent skipped this

question

Q17: Race/ethnicity unknown: 3

Q18: White, non-Hispanic: 3

PAGE 5: Special Needs

Q19: Please indicate whether you worked with students 504 Plan, IEP
with the following special needs. Check all that apply.

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