Student Teaching Diversity Report SurveyMonkey

#147
COMPLETE
Collector: Web Link (Web Link)
Started: Wednesday, September 06, 2017 4:46:47 PM
Last Modified: Wednesday, September 06, 2017 5:01:39 PM
Time Spent: 00:14:51
IP Address: 72.218.24.4

Page 1: Student Teacher Information

Q1 Student Teacher Name:

Kelly Smalley

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 Fall 2017
experience:

Page 2: Classroom Specifics

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

general education classroom

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

Q6 Number of students in the classroom:

20

Page 3: Student Gender and Economic Status

Q7 Male students:

Q8 Female students:

12

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Q9 Free/Reduced Lunch students:

50%

Q10 Not Free/Reduced Lunch students:

50%

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:

11

Page 5: Special Needs

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Q19 Please indicate whether you worked with students Bilingual

with the following special needs. Check all that apply.

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