Student Teaching Diversity Report

#59

SurveyMonkey

COMPLETE
Collector: Web Link (Web Link)
Started: Monday, December 07, 2015 10:02:45 PM
Last Modified: Monday, December 07, 2015 10:07:09 PM
Time Spent: 00:04:24
IP Address: 71.120.214.9

PAGE 1: Student Teacher Information

Q1: Student Teacher Name:

Jessie Caprio

Q2: Please indicate on which of the following you are

reporting information:

Student Teaching Placement 2

Q3: Semester and year in which you are reporting this

experience:

Fall 2015

PAGE 2: Classroom Specifics

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

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

Q6: Number of students in the classroom:

27

PAGE 3: Student Gender and Economic Status

Q7: Male students:

14

Q8: Female students:

13

Q9: Free/Reduced Lunch students:

Q10: Not Free/Reduced Lunch students:

25

PAGE 4: Student Race/Ethnicity

Q11: American Indian or Alaskan Native:

Q12: Asian or Pacific Islander:

Q13: Black, non-Hispanic

Q14: Hispanic:

1/2

Student Teaching Diversity Report

SurveyMonkey

Q15: Multiracial

Q16: Non-resident Alien:

Q17: Race/ethnicity unknown:

Q18: White, non-Hispanic:

23

PAGE 5: Special Needs

Q19: Please indicate whether you worked with students

with the following special needs. Check all that apply.

2/2

None