Appendix B SPP 2024-25 Preliminary Activities - Screener CR

School Pulse Panel (SPP) 2024-25

Preliminary Field Activities

OMB# 1850-0969 v.14

Appendix B

Screener Survey

National Center for Education Statistics (NCES)

U.S. Department of Education

October 2023

revised November 2023

revised April 2024

Table of Contents

School/District Point of Contact Screener 3

School Point of Contact Screener

Screen1 Q1. Please confirm or enter the following information about your school: {Information will be pre-populated when available}

School Name: [Auto-filled information when available]

Principal/Head of School First Name: [Auto-filled information when available]

Principal/Head of School Last Name: [Auto-filled information when available]

Principal/Head of School Phone Number: [Auto-filled information when available]

School Address 1: [Auto-filled information when available]

School Address 2: [Auto-filled information when available]

City: [Auto-filled information when available]

State: [Auto-filled information when available]

Zip Code: [Auto-filled information when available]

• All information above is correct

• School name needs to be updated

• Principal/Head of School name needs to be updated

• Principial/Head of School email needs to be updated

• Principal/Head of School phone numbers needs to be updated

• School address needs to be updated

School Name: _______________________

Principal/Head of School First Name: _______________________

Principal/Head of School Last Name: _______________________

Principal/Head of School Phone Number: _______________________

School Address 1: _______________________

School Address 2: _______________________

City: _______________________________

State: ________________________________

Zip Code: ___________________________

Screen2a Q2. Is this also the MAILING address for your school?

• Yes

• No

Screen2b Q3. Please enter the MAILING address for your school. {Display if Screen2a = No}

1. Name: ______________

2. Mailing Address 1: _______________

3. Mailing Address 2: _______________

4. City: ____________________

5. State: ___________________

6. Zip Code: _____________________

Screen3 Q4. Which of the following grades or grade equivalents are offered at your school?

• Kindergarten

• 1^st grade

• 2^nd grade

• 3^rd grade

• 4^th grade

• 5^th grade

• 6^th grade

• 7^th grade

• 8^th grade

• 9^th grade

• 10^th grade

• 11^th grade

• 12^th grade

Screen4 Q5b. This survey will collect information on a variety of topics related to your school’s operations during the 2024-25 school year, including, but not limited to: staffing/hiring challenges, absenteeism, student and staff mental health, and student behavior, among others. Please identify the best person in your school for us to contact for this survey. As principal/head of school, you may be this person, or you can identify another school staff member to serve in this role. This person will serve as your school’s primary person of contact for this study.

The primary person of contact will receive future communications regarding the School Pulse Panel, including monthly survey links. This person should be a school staff member who can respond to monthly surveys. This person is responsible for collecting information necessary, which may be from other staff, to answer survey items and submit completed surveys online.

• I, the principal/head of school, will be the primary person of contact for the School Pulse Panel.

POC First Name: ____________________

POC Last Name

POC Job Title: ____________________

POC Email: ____________________

POC Work Phone Number: ____________________

POC Phone Extension: _________________

Screen5 Q6b. Please identify an alternative person of contact.

The alternative person of contact will be contacted if the primary person of contact leaves the school or is otherwise unavailable during a collection period.

• I, the principal/head of school, will be the alternative person of contact for the School Pulse Panel.

ALT First Name: ____________________

ALT Last Name: ____________________

ALT Job Title: ____________________

ALT Email: ____________________

ALT Work Phone Number: ____________________

ALT Work Phone Extension: _________________

Screen6a Q7. Please confirm the point of contact and mailing address where we should send the $200 for completing the monthly survey.

Debit Card Point of Contact: [Principal Name]
Mailing Address 1: [Mailing Address Street 1]

Mailing Address 2: [Mailing Address Street 2]

City: [Mailing Address City]

State: [Mailing Address State]

ZIP Code: [Mailing Address ZIP]

• Debit card information is correct

• Debit card information needs to be updated

Screen6b Q7_update. Please provide the following. {Display if Screen6a = “debit card information needs to be updated”}

Debit Card Point of Contact: ______________

Address 1: _______________

Address 2: _______________

City: ____________________

State: ___________________

Zip Code: _____________________

NCES is authorized to conduct this survey by the Education Sciences Reform Act of 2002 (ESRA 2002, 20 U.S.C. §9543). All of the information you provide may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required by law (20 U.S.C. §9573 and 6 U.S.C. §151). Reports of the findings from the survey will not identify participating districts, schools, or staff. Individual responses will be combined with those from other participants to produce summary statistics and reports.