Student Teaching Diversity Report SurveyMonkey

#305
COMPLETE
Collector: Web Link (Web Link)
Started: Thursday, January 30, 2020 10:54:33 AM
Last Modified: Thursday, January 30, 2020 11:00:33 AM
Time Spent: 00:06:00
IP Address: 204.126.10.209

Page 1: Student Teacher Information

Q1 Student Teacher Name:

Samantha Mattfield

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 2020
experience:

Page 2: Classroom Specifics

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

General Education

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

3rd grade

Q6 Number of students in the classroom:

18

Page 3: Student Gender and Economic Status

Q7 Male students:

10

Q8 Female students:

1/3
 Student Teaching Diversity Report SurveyMonkey

Q9 Free/Reduced Lunch students:

12

Q10 Not Free/Reduced Lunch students:

Page 4: Student Race/Ethnicity

Q11 American Indian or Alaskan Native:

Q12 Asian or Pacific Islander:

Q13 Black, non-Hispanic

Q14 Hispanic:

Q15 Multiracial

Q16 Non-resident Alien:

Q17 Race/ethnicity unknown:

Q18 White, non-Hispanic:

Page 5: Special Needs

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

3/3