To start, we have eight short questions about you and your experiences.


    1. What is your gender? Male Female

    2. Are you currently teaching or training to become a teacher?

    Currently teaching Training to become a teacher Other
    If other, please describe.

    3. What is your primary ethnic group?

    Caucasian African American Hispanic American Asian American Native American Other
    If other, please describe.

    4. Do you have a bachelor’s degree?

    yes no

    5. Do you have a master’s degree?

    yes no

    6. Do you have any other degrees? If so, check all that apply.

    Associate degree SECOND bachelor’s degree SECOND master’s degree Educational specialist or professional diploma (at least one year beyond master’s level) Certificate of Advanced Graduate Studies Doctorate or first professional degree (Ph.D., Ed.D, M.D., J.D., S.D., D.D.S.)

    7. What type of certificate do you hold in the teaching profession?

    Advanced professional certificate or regular or standard state certificate. Probationary certificate (initial certificate issued after satisfying all requirements except the completion of a probationary period) Provisional or other type given to persons still participating in what the state calls an ‘alternative certificate program’ Temporary certificate (requires some additional college coursework and/or student teaching before regular certification can be obtained) Emergency certificate or waiver (issued to person with insufficient teacher preparation who must complete a regular certification program in order to continue teaching) None

    8. Please list the number of years of experience you have in teaching
    the following grades full time. (Do not include this year.)

    Years teaching Pre-Kindergarten Years teaching K-5 Years teaching 6-8 Years teaching 9-12
    Other (describe)

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