OMB No. 1121-XXXX; Approval Expires XX/XX/XXXX Attachment 2: Officer Rostering Form
Bureau
of Justice Statistics
2019 Survey of Law Enforcement Personnel
in Schools (SLEPS)
School Resource Officer Rostering Form
Please use the table on the following pages to list all of the sworn officers from your jurisdiction who are assigned to work in any K–12 public school. The total number should match the totals provided in Questions 20a and 21 of the LEA survey. We will use this list to randomly select some officers to receive a survey about activities performed by sworn law enforcement officers assigned to schools. This list will only be used for statistical purposes and will be kept confidential.
Options for listing officers:
Provide the names and/or badge numbers of these officers.
If your agency would prefer to provide information other than the name and badge number of these officers, please list an alias or other information that you can use to identify these officers in the table below. Please keep a copy of the list linking the alias to the individuals so that you can distribute the SRO-level survey to the sampled officers. We will send out the officer survey materials shortly after the due date of the agency-level survey.
It is estimated that it will take 10 minutes, on average, to complete this Rostering Form.
Please provide your completed Rostering Form by:
using the enclosed Business Reply Envelope;
faxing to RTI’s secure fax line at (XXX) XXX-XXX; or
contacting Dustin Williams with RTI by telephone at (866) 309-4564 to make other arrangements.
If you have any questions, visit the SLEPS web site at https://bjslecs.org/sleps2019 or contact Dustin Williams at RTI by telephone at (866) 309-4564 or by email at sleps@rti.org.
INFORMED CONSENT
Description and Purpose of the Survey of Law Enforcement Personnel in Schools (SLEPS): SLEPS collects data on law enforcement agencies and school resource officers across the United States. You have been selected from a scientific sample of approximately 2,000 law enforcement agencies from across the country.
Financial Considerations: There is no monetary incentive for completing the survey.
Possible Benefits and Risks: There are no direct benefits to you for participating in the survey. The potential exists for loss of privacy, though our procedures are designed to protect and secure your information.
Statement of Consent: I have read the description of this survey provided above and I understand it. I have been informed of the risks and benefits involved, and all my questions have been answered to my satisfaction. Furthermore, I have been assured that any future questions that I may have will also be answered. I freely and voluntarily agree to participate in SLEPS.
By completing this roster, I am indicating my agreement.
Officer’s Initials OR Other
|
Officer’s Rank |
Record the ethnicity of each SRO using the letter corresponding to the correct category below:
|
Record the race of each SRO using the letter corresponding to the correct category below:
A. White
D. Asian
F. Other (Please specify) |
Indicate whether each SRO listed is male (M) or female (F) |
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If you have more officers working in schools, please use the additional pages provided with this form.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Stringer, Chris |
File Modified | 0000-00-00 |
File Created | 2021-01-14 |