APPENDIX B
Crosswalk of GK-12 Data Elements Indicating New Elements
Data Elements of Graduate Teaching Fellows in K–12 Education (GK–12)
Distance Monitoring System
Previously Entered by PI |
Revised Elements |
New Elements |
Question |
Staff and Project Participant Characteristics i |
Project Implementation Characteristicsii |
Project Outputs iii |
Section I. Data Entered by Principal Investigator |
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Award Information
NSF Award ID Grantee Institution Award Title Award Start Date Award End Date |
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Award Effort Information |
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Award Title |
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Effort Title |
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Associated Colleges and Universities |
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Schools |
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Award Evaluator |
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Award Discipline(s) Astronomy Behavioral Sciences Biological Sciences Chemistry Computer/Information Sciences Economic Science Engineering Environmental Science Geosciences Mathematics Physics/Physical Sciences Social Sciences Other |
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Other Award Discipline (only if you chose “Other” above) |
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Award Design Model Self-Contained Expository |
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Award Status Planning Recruiting Training Completed In Classroom |
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Award URL |
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Partner Organization(s) |
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Other Partner Organization’s Name (only if you chose “Other” above) |
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Additional Funding Source Information |
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Source Name |
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Additional Funding Source Type State Government Federal Government Local Government Home Institution Business Foundation Other |
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Other Source Type (only if you chose “Other” above) |
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Amount of Additional Funding |
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Associated Colleges and Universities Information |
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Institution Name |
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City |
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State |
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ZIP Code |
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FICE Code |
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School Information |
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School Name |
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School Level Elementary School Grades Middle School Grades High School Grades Prekindergarten or Kindergarten Through Middle School Middle School Through High School |
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State District Name |
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School Setting/Location Urban Suburban Rural |
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Start Date for School Involvement in Fellowship |
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End Date for School Involvement in Fellowship |
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Percentage of Eligible Students for Lunch Programs Not Applicable 1 – 10% 11 – 20% 21 – 30% 31 – 40% 41 – 50% 51 – 60% 61 – 70% 71 - 80% 81 – 90% 91 – 100% |
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Class Information |
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Class Name |
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Grade K – Kindergarten 1 – 1st Grade 2 – 2nd Grade 3 – 3rd Grade 4 – 4th Grade 5 – 5th Grade 6 – 6th Grade 7 – 7th Grade 8 – 8th Grade 9 – 9th Grade 10 – 10th Grade 11 – 11th Grade 12 – 12th Grade |
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Subject Mathematics – General Mathematics – Elementary School Mathematics – Middle School Mathematics – High School (Secondary) Science - Biology Science - Chemistry Science - Earth Science Science - Elementary Science Science - General Science Science - Integrated Science Science - Physical Science Science - Physics Art Computer Science English Foreign Language History/Social Studies Music Other |
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Other Subject (only if you chose “Other” above) |
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Number of Students |
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Participant Data (Award Evaluator Information) |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Participant Data (Principal Investigator (PI)/Co-PI Information) |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix Data Entry Privileges Primary status |
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Phone number |
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Phone extension |
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E-mail address |
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Participant Data (Co-PI Information) Co-PI/PI Title Co-PI/PI Academic Discipline Astronomy Behavioral Sciences Biological Sciences Chemistry Computer/Information Sciences Economic Science Engineering Environmental Science Geosciences Mathematics Physics/Physical Sciences Social Sciences Other Co-PI/PI Other Discipline (only if you chose “Other” above) Institution |
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Participant Data (Graduate Fellow Information) |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Social Security Number |
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Phone Number |
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Email Address |
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Fellowship Start Date Month Year |
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Fellowship End Date Month Year |
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Is this graduate fellow supported by NSF-GK-12 Funds? Yes No |
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Total Stipend Received By Graduate Fellow for participating in GK-12 fellowship Full 100% of $30,000 Partial 100% by other Other |
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Participant Data (Undergraduate Fellow Information) |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Race (select one or more) American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander Not Reported White |
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Ethnicity Not Hispanic or Latino Hispanic or Latino Not Reported |
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Gender Male Female Not Reported |
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Disability Hearing Impairment Mobility or Orthopedic Impairment None Not Reported Other Visual Impairment |
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Other Disability (only if you chose “Other” above) |
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Undergraduate Fellow InformationHome Institution of Fellow Social Security Number Supported by NSF GK-12 funds Date of Birth Fellowship Start Date Fellowship End Date Fellow Discipline Astronomy Behavioral Sciences Biological Sciences Chemistry Computer/Information Sciences Economic Science Engineering Environmental Science Geosciences Mathematics Physics/Physical Sciences Social Sciences Other Fellow Academic Level During Fellowship Year Undergrad Junior Undergrad Senior Baccalaureate Degree
School Class |
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Participant Data (Cooperating Teacher Information) |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Phone Number |
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Phone Extension |
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E-mail Address |
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Participant Data (Other Participant Information) |
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Title |
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First Name |
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Middle Name |
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Last Name |
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Suffix |
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Participant Description (check here for data entry staff) |
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Phone Number |
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Phone Extension |
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E-mail Address
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Achievements and Products Related to GK-12 Activities |
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Journal Articles In Refereed Publications |
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Author(s) |
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Article Title |
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Publication Name |
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Volume |
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Number |
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Year |
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Pages |
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Journal Articles In Non-Refereed Publications |
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Author(s) |
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Article Title |
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Publication Name |
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Volume |
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Number |
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Year |
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Pages |
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Books |
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Author(s) |
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Book Title |
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Publisher |
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Year |
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ISBN# |
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Book Chapters |
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X |
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Author(s) |
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Chapter Title |
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Book Title |
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Editor(s) |
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Publisher |
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Year |
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ISBN# |
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Curriculum/Module Development |
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Author/Contributor |
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Title |
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Grade Band |
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Academic Disciplines Astronomy
Physics |
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Other (please specify) |
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Brief Description |
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Conference Publications |
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Author(s) |
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Paper Title |
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Conference |
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Year |
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Pages |
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Conference Presentations |
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X |
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Author(s) |
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Name of the Conference |
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Presentation Title |
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Date |
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Location |
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Organization |
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Other (Textbox) |
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Program outreach informationOutreach activities include your GK faculty and/or GK Trainees being featured on TV, radio, in magazine articles or otherwise in the media; talks, presentations, workshops given by GK-12 faculty, trainees and/or associates to school groups, civic groups, non-scientifically based professional groups, members of the government or the general public. Please separately list in the text box below the type of outreach activity, the organization/magazine/radio station/etc. for which the outreach was done, the location, who in your GK-12 did the outreach and date. |
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Section II. Data Entered by Graduate Fellow |
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Fellow’s Name Date of Birth (month, day, year) Social Security Number Data will be pre-filled with data entered by PI |
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Fellow’s Current Contact Information: Fellow’s Current Address Fellow’s Current City Fellow’s Current State Fellow’s Current ZIP Fellow’s Phone Fellow’s E-mail Address |
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School Name [Pre-populated dropdown list] |
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Class [Pre-populated dropdown list] |
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Fellow’s Permanent Contact InformationFellow’s Contact Name Fellow’s Permanent Address Fellow’s Permanent City Fellow’s Permanent State Fellow’s Permanent ZIP Fellow’s Phone Fellow’s Personal E-mail Address |
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Fellow’s Demographic Information
Ethnicity—please select one Hispanic or Latino Not Hispanic or Latino Not Reported
Race—please select all that apply American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Not Reported
Gender—please select one Male Female Not Reported
Disability Status—please select all that apply Hearing Impairment Visual Impairment Mobility or Orthopedic Impairment NoneOther (please specify)Not Reported |
X |
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Undergraduate degree institution by state
Undergraduate degree type BS BA Other (please specify)
Undergraduate degree major
Undergraduate degree date of completion |
X |
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Previous Graduate Degree(s) Completed
Previous graduate degree institution by state
Previous graduate degree type MA MS Other (please specify)
Previous graduate degree major
Previous graduate degree date of completion |
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Current Graduate Work Current Graduate Institution By State
Date when you started your graduate program:
Fellow’s academic level during fellowship year Master’s 1st year Master’s 2nd year Master’s 3rd year Doctorate 1st year Doctorate 2nd year Doctorate 3rd year Doctorate 4th year Doctorate 5th year Other (specify)
Discipline – please select one Astronomy Physics
Sub-Discipline
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Research Advisor Information Research Advisor Full Name
Research Advisor’s Academic Discipline Astronomy Physics
Research Advisor’s Contact Information: Phone E-mail address |
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Achievements During The Gk-12 Project ParticipationHonors and RecognitionName Year Society/Granting Organization Fellowship, Scholarship, and Grant Other Than GK-12Title of the Proposal Year Awarded Awarding Agency Other Scholarly Achievements[Text box will be provided to collect detailed information] |
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On average, how many hours per week do you spend on GK-12 activities? |
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On average, how many hours per week do you spend on the following GK-12 activities?
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On average, how many hours do you spend on your own research? |
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Has participation in GK-12 activities affected your graduate research productivity? (Check all that apply)
Because of GK-12 I....
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What percentage of seminars and workshops, provided by your GK-12 project, prepared you for your work as a fellow? |
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X |
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In what ways have you incorporated your research and/or area of scientific expertise into K12 classroom activities? |
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Fellow’s Fellowship Results |
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List up to three (3) accomplishments from your participation in GK-12. |
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Check the areas in which your knowledge/skills have improved as a result of your GK-12 participation
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Have K12 students you worked with improved in the following areas as a result of GK-12 participation? [Check areas of improvement]
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X |
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Has your GK-12 participation affected your professional pursuits and career goals as a scientist? (Check all that apply) Because of GK-12 I....
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X |
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Did you visit a foreign country as part of your GK-12 fellowship? If yes:
Please select the country or countries you visited (from list)
Describe your participation in this international GK-12 component. |
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Please list up to three (3) concerns or areas for improvement about the GK-12 program or your experience in the program. |
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Section II. Data Entered by Cooperating Teacher |
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Cooperating Teacher’s Name Data will be pre-filled with data entered by PI |
X |
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Cooperating Teacher’s Current Contact Information
Cooperating Teacher’s Current Address: Cooperating Teacher’s Current City: Cooperating Teacher’s Current State– please select one Cooperating Teacher’s Current ZIP/Postal Code: Cooperating Teacher’s Phone Cooperating Teacher’s E-mail Address
Data will be pre-filled with data entered by PI |
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School Name
Class
Data will be pre-filled with data entered by PI |
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Cooperating Teacher’s Demographic Information
Ethnicity—please select one Hispanic or Latino Not Hispanic or Latino Not Reported
Race—please select all that apply American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Not Reported
Gender—please select one Male Female Not Reported
Disability Status—please select all that apply Hearing Impairment Visual Impairment Mobility or Orthopedic Impairment NoneOther (please specify)Not Reported
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Undergraduate Degree(s) Completed
Undergraduate degree institution by state Undergraduate degree type – please select one BS BA Other (please specify)
Undergraduate degree major Undergraduate degree date of completion:
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Graduate Degree(s) Completed
Graduate degree institution by state – please select one Graduate degree type – please select one MS MA Ed.D Ph.D Other (please specify)
Graduate degree major Graduate degree date of completion:
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Teaching Experience And Credentials
Number of teaching years (at all schools)
Grade(s) certified to teach Early childhood Elementary Middle/junior high High school
Subject(s) certified to teach Mathematics) Computer/Technology Science—Biology Science—Chemistry Science—Earth Science Science—Elementary Science Science—General Science Science—Integrated Science Science—Physical Science Science—Physics Other (please specify)
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On average, how many hours per week do you spend on GK-12 activities? |
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On average, how many hours per week do you spend on the following GK-12 activities? – Write the number of hours for each activity
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Did you attend GK-12 seminars, workshops, regular meetings or conferences? If yes, briefly describe up to three (3) seminars, workshops, regular meetings or conferences related to your GK-12 project that you have attended. |
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Check the activities in which the GK-12 fellow participated.
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Cooperating Teacher’s Experience |
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Has your professional practice in the following areas improved as a result of your participation in GK-12? Check all that apply.
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X |
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Has your involvement in the GK-12 program resulted in any of the following? Indicate each that apply.
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X |
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As a result of your participation in GK-12 have you observed improvement in your students in the following areas:
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X |
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Please specify up to three activities or highlights that best describe how you benefited from the participation/experience in the GK-12 project. |
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Please indicate up to three concerns from your experience in the GK-12 project. |
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X |
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Please briefly describe the ways that you plan to incorporate activities and ideas gained from GK-12 into your classroom? |
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X |
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Please briefly describe the ways that you plan to share activities and ideas gained from GK-12 with other educators? |
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X |
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Cooperating Teacher’s Achievement During GK-12 Project Participation |
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Enter the requested information about your achievements during your involvement in the GK-12 project in the space below. Honors and Recognition
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X |
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Fellowship, Scholarship, and Grant Other Than GK-12
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X |
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Other Scholarly Achievements |
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X |
i Elements of these characteristics include: Name, address, date of birth, gender, ethnicity, race, disability status, class, major, grade point average, yearly fellowship or stipend amount, or project role.
ii Elements of these characteristics include: Sources and amount of funds, fellowships, scholarships, traineeships, partnerships, training, research methods.
iii Elements of these characteristics include: research findings, publications, presentations, degrees granted, educational materials.
File Type | application/msword |
File Title | Common |
Author | mark morgan |
File Modified | 2007-04-06 |
File Created | 2007-04-06 |