August, 1999

1	Regular elementary or secondary school that serves a wide variety of students
2	School that serves only students with disabilities
3	School that specializes in a particular subject area or theme, sometimes called a magnet school
4	Vocational-technical school
5	Alternative school
6	Charter school
7	Juvenile justice facility
8	Another kind of school (please describe): _________________________________

1	Public school
2	Private school
3	Residential/boarding school

0	Prekindergarten	4	4th grade	9	9th grade
K	Kindergarten	5	5th grade	10	10th grade
1	1st grade	6	6th grade	11	11th grade
2	2nd grade	7	7th grade	12	12th grade
3	3rd grade	8	8th grade	99	Nongraded

_______________

Number of students enrolled

Percentage of students	OR	Number of students
____________		__________	African-American or Black
____________		__________	American Indian or Alaska Native
____________		__________	Asian
____________		__________	Native Hawaiian, or other Pacific Islander
____________		__________	Caucasian or White
____________		__________	Hispanic or Latino
____________		__________	Other

Number of students who have the following as a primary disability
____________	Autism
____________	Deaf-blindness
____________	Developmental delay
____________	Emotional or behavioral impairment
____________	Hearing impairment/deafness
____________	Learning disability
____________	Mental retardation/cognitive impairment
____________	Orthopedic impairment
____________	Other health impairment
____________	Multiple disabilities
____________	Speech or language impairment
____________	Traumatic brain injury
____________	Visual impairment/blindness
____________	Other: _______________________________________

_____________

Number of ELL (or LEP or ESL) students

Approximate total FTE in a typical week
____________	General education classroom teachers
____________	Special education classroom teachers (self-contained or single-subject teachers)
____________	Special education resource room teachers
____________	Reading specialists
____________	Speech/communication therapists or pathologists
____________	Nursing/medical personnel
____________	School psychologist or other diagnostic personnel
____________	Guidance counselors
____________	Other related services personnel (i.e., occupational or physical therapist)
____________	Paid teacher aides/instructional assistants
____________	Librarians/library aides or library staff
____________	Itinerant or special subjects personnel not already accounted for above (e.g., district music or physical education personnel who teach a specific subject at multiple schools or come to the school for one subject)
___________	Administrators (e.g., principal, vice-principals)

Number of teachers
____________	a. Are fully credentialed for primary teaching assignment?
____________	b. Are new to this school?
____________	c. Have less than 3 years teaching experience?

	Additional academic programs
1	Supplemental instructional services in reading or language arts
2	Supplemental instructional services in math
3	Academic supports, such as academic clubs, tutoring or mentoring assistance outside of regular class offerings (e.g., homework club, Saturday academies)
4	Diagnostic and prescriptive services (services provided by trained professionals to diagnose learning problems and to plan and provide therapeutic or educational programs)
5	Programs for gifted and talented students
	Enrichment and recreation programs
6	Extended day, before-school or after-school enrichment programs (e.g., Beacons programs, cultural activity groups, special interest groups)
8	An extended school year program (e.g., classes or activities in the summer)
9	Weekend program for students
10	Band, chorus, drama, or other performing opportunities for students
11	Organized school sports activities before or after school
	Health/mental health services
12	School-based health services (services provided by trained professionals–e.g., physician, physician assistant, nurse, or nurse practitioner–to diagnose and treat health problems of students)
13	Counseling or pupil services
	Parent or community programs
14	A family literacy program
15	Parent education or other classes for parents
16	A parent liaison
17	A family resource center or drop-in center for parents or community members
18	Services for out-of-school youth
19	School-to-work activities
	Language-learning programs
20	Instruction in English for English language learners, such as ESL
21	Instruction in languages other than English, such as bilingual education
	Other programs/initiatives
22	Title I
23	A class size reduction initiative
24	A schoolwide reform project (e.g., Success for All, Comer Schools, Accelerated Schools)
25	A conflict resolution/conflict management program

1	General education/inclusion program with special services provided in general education classroom
2	Part-time resource room for special education students
3	Self-contained special education classrooms
4	General and special education co-taught classes
5	Other : _______________________________________________________

1	Yes PLEASE CONTINUE WITH QUESTION E1b.
2	No PLEASE GO TO QUESTION E2.

1	Required to follow the same procedures and meet the same standards for successful completion as regular education students.
2	Provided special accommodation in taking the test (e.g., reader, dictation, more time).
3	Provided with a modified version of the test (e.g., shortened version, different test materials covering same content).
4	Given the option to complete an alternate assessment.

0	Not applicable (no students with disabilities are exempted from these tests)
1	Principal decision
2	IEP committee decision
3	Individual general education teacher decision
4	Individual special education teacher decision
5	Parental request
6	Other: _________________________________________________________

1	General policy statement (e.g., "standards will apply to all students")
2	Specific references to students with disabilities (e.g., "standards will apply to students with a diversity of learner styles, including students with disabilities")
3	Specific written accommodations and adaptations
4	Individual students handled on a case-by-case basis
5	No special references to students with disabilities
6	Other: ___________________________________________________________

		Yes	No
a.	For general education students?	1	2
b.	For special education students?	1	2

1	Parents are given interim reports or report cards on student performance or attendance.
2	Parents are asked to sign off on homework.
3	Parents are given positive phone calls or notes from teachers.
4	Parents have access to a school-sponsored "homework hotline."
5	Parents are given examples of work that meets high standards.
6	Parents have access to the school’s Web site with information specific to them.
7	A regular system for communicating with parents exists, such as a newsletter or phone tree.
8	None of these.

1	Open house or "back-to-school night"
2	Regularly scheduled schoolwide parent-teacher conferences
3	Special subject-area events to which parents are invited (e.g., science fairs)
4	Parent presentations at "career days" or other occupational development activities
5	Parent education workshops or courses
6	Written contract between school and parent
7	Parent-child learning activities at school (e.g., "Family Math")
8	Parents as volunteers in the school
9	Parents as paid classroom aides
10	Parents involved in instructional issues (e.g., materials selection)
11	Parents involved in governance (e.g., on school site management council)
12	At-home parent-child learning activities to support school objectives
13	Services to support parent involvement (e.g., child care for school events)
14	Translation of school information into languages other than English used by parents
15	Other: _________________________________________________________
16	None of these

G2. To what school(s) do students from your school typically go after finishing this school?

SEELS DESIGN DOCUMENTS