CESDP Teacher Questionnaire

THANK YOU very much for taking the time to fill out this questionnaire. This form is part of an ongoing evaluation process being conducted by the Center for the Education and Study of Diverse Populations (CESDP) and the Center for Positive Practices (CPP). Only CESDP, CPP, and you personally will be privileged to see your individual responses. Any research shared with other institutions, your employer, or the public will only include reports of group-level data, if any at all, in order to protect your individual privacy. The evaluation team is asking for your name so that we can track whether participants experience varying levels of professional growth over the course of the program.

Please scroll below to begin answering questions...

Section I: Personal Information

Implied Consent

The information you provide on this form may be used as continuous improvement feedback to the CESDP for improving its technical assistance services, and to assess its programs for evidence of effectiveness. Filling in the form below affirms that you are over 18 years of age, and that you consent to have your answers to this questionnaire included in our research and evaluation processes. Thank you!

1. Your Name:

2. Position/Title (If employed in education, or student):

3. Home Mailing Address (home # and street name):

4. City, State Zip:

5. Work Telephone 505-123-4567:

6. Home Telephone (used only for important circumstances):

7. Email:

8. Signed (Not Required Online):

9. Date (Not Required Online):

Section II: Professional Information

10. Grade(s) you teach: Check all that apply, including as teacher assistant, if applicable:

11.Years of teaching experience:

12. Years of bilingual/ESL teaching experience:

13. Do you have a valid in-state teaching license?

Yes

N/A or Don't Know

14. Have you been formally enrolled into the present professional development program?

Yes

N/A or Don't Know

15. Do you have teaching certification from another country?

Yes

N/A or Don't Know

16. List any other special certifications you may have (e.g. Bilingual/ESL, Special Education, etc.):

17. List any languages other than English for which you have oral proficiency:

18. Present school where you are a teacher (if applicable).

Example	A. Formal Training (Hours)	B. Professional Experience (Years)	C. Formal Education (Credit Hours)
Example: Language: Navajo
Example: Language: Spanish

Description	A. Formal Training (Hours)	B. Professional Experience (Years)	C. Formal Education (Credit Hours)
43. Language Competency: English
44. Language Competency: Spanish
45. Language Competency: American Indian dialect (If applicable, please specify in comments, Item 60 below)
46. Language Competency: Other (If applicable, please specify in comments, Item 60 below)
47. Methods, strategies, and materials for bilingual/ESL classrooms.
48. Foundations of bilingual/ESL instruction
49. Understanding language acquisition and cognition
50. Assessment of linguistically diverse populations
51. Integrating language acquisition into content instruction
52. Parent and community involvement in education
53. Sheltered English or ESL instruction
54. Teacher mentoring in education
55. Peer coaching, cognitive coaching, and/or peer tutoring
56. Working with Native American students
57. Working with recent immigrant students
58. Working with English Language Learners
59. Dual Language bilingual education

CESDP Teacher Questionnaire

Section I: Personal Information

Implied Consent

Section II: Professional Information

Section III: Personal Beliefs. I BELIEVE THAT...

Section IV: Personal Efficacy. I FEEL CONFIDENT THAT I CAN…

Section V: Previous Related Training, Experience, and/or Education