Student Teaching Diversity Report

#385
COMPLETE
Collector:
Web Link
(Web Link)
Started:
Monday, March 14, 2022 8:49:38 PM
Last Modified:
Monday, March 14, 2022 8:52:23 PM
Time Spent:
00:02:45
IP Address:
172.58.227.36

Page 1: Student Teacher Information

Q1
Student Teacher Name:

Samuel Black

Q2 Student Teaching Placement 2

Please indicate on which of the following you are reporting

information:

Q3 Spring 2022

Semester and year in which you are reporting this

experience:

Page 2: Classroom Specifics

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

Gifted and inclusive

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

9th

Q6
Number of students in the classroom:

25

Page 3: Student Gender and Economic Status

1/3
 Student Teaching Diversity Report

Q7
Male students:

10

Q8
Female students:

15

Q9
Free/Reduced Lunch students:

N/A

Q10
Not Free/Reduced Lunch students:

N/A

Page 4: Student Race/Ethnicity

Q11
American Indian or Alaskan Native:

Q12
Asian or Pacific Islander:

Q13
Black, non-Hispanic

Q14
Hispanic:

2/3
 Student Teaching Diversity Report

Q15
Multiracial

Q16
Non-resident Alien:

N/A

Q17
Race/ethnicity unknown:

N/A

Q18
White, non-Hispanic:

Page 5: Special Needs

Q19 ESL,

Please indicate whether you worked with students with the Gifted/Talented,
following special needs. Check all that apply.
504 Plan,

IEP

3/3