Form 1 AC Longitudinal Contract Info Phone Questionnaire

Abt SRBI INC. STUDY NUMBER 4807a

275 7^th AVE, SUITE 2700

NEW YORK, NEW YORK 10001

Longitudinal Study of AmeriCorps Location

AmeriCorps Member Location (Treatment Group)

Name: Address:

ID:

Home Phone 1:

Phone 2:

CATI – PLEASE SET SYSTEM TO UPDATE PHONE NUMBER.

MANY OF THESE PHONE #s WILL BE FAMILY OR FRIENDS OF RESP.

Hello. May I speak to ______. (My name is __________. I’m calling on behalf of AmeriCorps NCCC and State and National programs. )

IF WRONG NUMBER AND MIGHT KNOW RESPONDENT, ASK

A1. Could you tell me at what number I could reach him/her?

(____) ___________________ CONTINUE WITH A2

A2. May I please have his/her current address? (even a city and state could help us locate him/her)

__________________________

__________________________

__________________________ THANK AND END –

IF NEW PHONE IN A1, UPDATE AND RESAMPLE.

IF ONLY NEW ADDRESS, DISPO AS ADDRESS UPDATE SO WE CAN MAIL NEW PACKET.

IF RESPONDENT IS PERMANENTLY DISABLED OR UNAVAILABLE, RECORD ANY DETAILS (like in military overseas, deaf, etc)

D. Why is he/she (permanently) unavailable?

[PROBE FOR REASON]

___________________________________________ THANK AND END – s/o AWAY

A. My name is __________. I’m calling on behalf of on behalf of AmeriCorps NCCC and State and National programs.

We are doing a quick call to see if you received our letter for a voluntary study. (IF NEEDED: This study is funded by the Corporation for National and Community Service. We sent you a letter a few weeks ago.)

Do you have a few minutes?

1 Yes SET QUAL LEVEL 1

2 No (set callback)

3 Refused (THANK AND END) SOFT REF

B. First, just to confirm, did you serve in AmeriCorps in 1999, 2000 or 2001.

1 Yes Continue

2 No - “I am sorry, we must have reached the wrong person.” THANK AND END. SO

3 REFUSED - THANK AND END – HARD REF

C. We are contacting you on behalf of the AmeriCorps and the Corporation for National and Community Service and recently sent you a letter and a contact information form. Did you receive it?

Yes…………1 ASK D

No…………….2 ASK C1

C1. OK. Let me just check to see if we have the right address for you? Is your address…READ AND CORRECT ADDRESS IF NEEDED ?

Yes, confirm over the phone…………0 GO to q10

Yes, confirm address to send in mail again …………1 ASK FOR ADDRESS

No, NOT WANT TO GIVE ADDRESS…2 SKIP TO F

REFUSED TO DO STUDY…3 THANK AND END – HARD REFUSED

Address: _____________________________________________

City, State, zip: ________________________________________ THANK GO TO q10

D. Have you completed it or would you please complete it and return it in the next two weeks?

I already completed and returned it………..1 GO TO F SET QUAL LEVEL 2

I will return in next two weeks……………..2 GO TO F

No, refused to complete it………………3 Go to E

5. Would you please tell me why you do not want to participate? Anything else?

___________________________________________ THANK AND END – HARD REF

F. CONTINUE WITH address verification QUESTIONS.

10. Is this the best telephone number to reach you at?

1 Yes

2 No

11. Is there (also) an alternate number, like a cell phone number, we could use to reach you?

1 Yes (_____)_________________

2 No

12. In case we cannot reach you at the numbers above it would be helpful if you would provide contact information for your parents or guardians who might know how to reach you:

1 Yes

2 No Skip to Q13.

PARENT: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ __ _

First MI Last

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

City State Zip Code

Phone ( __ __ __ ) __ __ __ - __ __ __ __

13. Would you please provide contact information for a friend who might know how to reach you?

1 Yes

2 No Skip to Q14.

FRIEND: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

First MI Last

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

City State Zip Code

Phone ( __ __ __ ) __ __ __ - __ __ __ __

14. If you have any questions, you may call us at 1-800-786-4816 or e-mail us at ServiceStudy@srbi.com. Thank you very much for you time today.

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