Student Teaching Diversity Report SurveyMonkey

#167
COMPLETE
Collector: Web Link (Web Link)
Started: Wednesday, November 29, 2017 4:12:27 PM
Last Modified: Wednesday, November 29, 2017 4:15:44 PM
Time Spent: 00:03:16
IP Address: 70.168.211.138

Page 1: Student Teacher Information

Q1 Student Teacher Name:

Kirstie Robison

Q2 Please indicate on which of the following you are Student Teaching Placement 2
reporting information:

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

Page 2: Classroom Specifics

Q4 Description of the type of classroom (i.e. inclusive, Respondent skipped this question
gifted):

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

first

Q6 Number of students in the classroom:

19

Page 3: Student Gender and Economic Status

Q7 Male students:

11

Q8 Female students:

1/2
 Student Teaching Diversity Report SurveyMonkey

Q9 Free/Reduced Lunch students:

Q10 Not Free/Reduced Lunch students:

19

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

Q14 Hispanic: Respondent skipped this question

Q15 Multiracial Respondent skipped this question

Q16 Non-resident Alien: Respondent skipped this question

Q17 Race/ethnicity unknown: Respondent skipped this question

Q18 White, non-Hispanic:

10

Page 5: Special Needs

Q19 Please indicate whether you worked with students 504 ,

with the following special needs. Check all that apply. Plan

IEP

2/2