Getting to KNOW YOUR SCHOOL
Data Collection Tool
Instructions: To complete this data collection tool, place a check mark( ) in the box next to the functioningprograms/componentsthat exist within your school; some areas (blank lines and tables) require more detailed information. ______
Safe Supportive Learning Environment that Promotes High Achievement for Every Student
SCHOOL Spirit(Does your school encourage school spirit?)
School Color(s) ____________/ Song/Anthem______
______
Mascot ______/ Uniform Policy
Motto ______
______/ Color(s) per grade? ______
______
______/ ______
Comments: ______
school Facilities(Describe your school facilities)
Art Room, ____ (# of facilities) / Library, ____ (# of facilities)Auditorium, ____ (# of facilities) / TV Studio, ____ (# of facilities)
Cooking Cafeteria, ____ (# of facilities) / Open-space
Satellite Cafeteria / ADA (Disability) Accessible
Computer Lab, ____ (# of labs) / Playground
Gymnasium, ____ (# of facilities) / Pool
Air-conditioned classrooms / Ben Carson Reading Room
Shared facility w/ an outside agency
If yes, with whom? ______/ Other: ______
Other: ______
Comments: ______
Health Services(Describe your health services)
Service / Provider (e.g. partner/ school) / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/week / Start/end dates(Write in) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in)
Dental
Vision
Mental Health
Service / Provider (e.g. partner/ school) / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/week / Start/end dates
(Write in) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in)
Medicine Distribution
Substance Abuse
Health Education Course(s)
Does your school have a health clinic on-site? yes, no
Comments: ______
Student SERVICES (Describe your student services)
Service / Provider (e.g. partner/ school) / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/week / Start/end dates(Write in) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in)
Assessment Services
Behavioral Interventions
Career Advisement
College Preparation
Counseling Services
Daycare Provider
GATE
Tutoring Services
Head Start
Intervention Programs
Special Education
Substance Abuse
Service / Provider (e.g. partner/ school) / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/week / Start/end dates
(Write in) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in)
Violence Prevention
Interpretive Services
International Baccalaureate
Mentoring Services
Other: ______
Other: ______
Comments: ______
Extended learning programs (Describe your extended learning programs)
Provider (e.g. partner/ school) / Cost to School / Cost to Partner / #of students served / # of hours/week / Start/end dates(Write in) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in)
After-school (Free to Parents)
After-school (Paid by Parents)
Before-school (Free to Parents)
Before-school (Paid by Parents)
TwilightSchool
Saturday Class
MSA/HSA Prep Course
Other: ______
Other: ______
Comments: ______
Organizations/clubs(Does your school offer organizations/clubs, beyond the provided curriculum?)
Academic Bowls / Language ClubsActivism Clubs / LGBT Clubs
Algebra Project / Mathematics Clubs
Art Organizations / Chess Clubs
Baltimore Urban Debate League / National Honor Society
Band/Choir / Peer mediation/judiciary board
Book/Reading Clubs / HIV/AIDS Awareness
Business Clubs / ROTC
Community Service / School Newspaper
Delta Epsilon Chi of America / Science Club
International/Multi-cultural Clubs / SkillsUSA
English Clubs / Speech Clubs
Engineering Clubs / Photography
Fashion/Modeling / Yearbook
Future Educators of America / Future Business Leaders of America
Health Occupations Students of America / Other: ______
Student Government (see questions below) / Other: ______
Student Government Questions:
- Does your school have class officers? ______
- Does the Student Government allocate student funds? yes, $______no
- Please describe the major roles of your school’s Student Government below: ______
- What other opportunities are available for students to exert leadership in the governance of the school?______
Comments: ______
Sports (Check the box to the left of the sport if your school has the corresponding team. In addition, please write in the number of males and females who play on the team; mark an X in the appropriate box (if the sport is varsity, JV, or club, and if the sport is played during the fall or spring season).
Sport / # of males on Team / # of females on Team / Varsity Team / J. Varsity Team / Extra-curricular / Club Team / Played in Fall / Played in Spring(check all that apply) / (write #) / (write #) / (Mark X) / (Mark X) / (Mark X) / (Mark X) / (Mark X)
Badminton
Baseball
Basketball
Cheerleading
Dance
Cross Country
Hockey
Football
Lacrosse
Soccer
Softball
Swimming
Tennis
Track & Field
Volleyball
Wrestling
Other: ______
Other: ______
Comments: ______
Transformational Leadership that Builds Teacher Quality to Promote High Achievement for Every Student
Educator Training/SuPPORT (Describe staff training and support)
In-house Professional DevelopmentHow often? ______/ Teacher Mentors
Teacher Handbook
(New)Teacher Mentoring Program / Teacher Resource Room
All teachers have their own classrooms
access to computers in their classrooms
Individual planning times / Faculty Lounge
Other: ______
Other: ______
Comments: ______
Educator Planning & instructional models(Describe teacher’s collaborative planning times and use of instructional models)
AreCollaborative planning times (check all that apply) / Instructional Models used (check all that apply)By discipline (e.g. math) / Self-Contained
By grade level / Explicit
Cross- grade level groups / Peer teaching
Heterogeneously / Cooperative Learning
Homogeneously / Departmentalized
Flexible (regrouped at what intervals?)
______/ DRTA
Special Education Co-teaching
Weekly / Other: ______
Monthly / Other: ______
Other: ______/ Other: ______
Comments: ______
Curriculum and Instruction that Support High Achievement for Every Student
instructional materials(Listcurricular, textbooks, programs, and academic interventionscurrently used)
Area / Curriculum(Write in) / Textbook(s)
(Write in) / Programs
(Write in) / Academic Interventions
(Write in)
Reading
Math
Area / Curriculum
(Write in) / Textbook(s)
(Write in) / Programs
(Write in) / Academic Interventions
(Write in)
Science
Social Studies
Other: ______
Other: ______
Comments: ______
Additional Curriculum & Instruction Questions:
- How long are class periods? _____ minutes
- How many interactive white boards does your school have? _____ boards
- Do you have a Gifted & Talented program? yesno
- If yes, how many students participate in the G & T program? ______
- If applicable, please list your G &T partners: ______
ArTS(What training/instruction are provided by your school?)
Arts / Provider (e.g. partner/ school) / Part of Curri-culum / After- School Program / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/ week / Start/ end dates(Write in) / (Mark X) / (Mark X) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in)
Vocal Music
Choir
Band
Instrumental
Arts / Provider (e.g. partner/ school) / Part of Curri-culum / After- School Program / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/ week / Start/ end dates
(Write in) / (Mark X) / (Mark X) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in)
Music
Dance
Visual Art
Computer Art
Graphic Design
Photography
Student Exhibits
Theater
Drama
Comments: ______
world languages(What world languages are taught at your school?)
World Languages / Provider (e.g. partner/school) / Cost to School / Cost to Partner / #of students served / Grades served / # of hours/ week / Start/ end dates / Part of Curri-culum / After- School Program(Write in) / (Enter $) / (Enter $) / (Write in) / (Write in) / (Write in) / (Write in) / (Mark X) / (Mark X)
Spanish
French
Russian
Chinese
German
Italian
Other: ______
Other: ______
Comments: ______
Family & Community Engagement that Promotes High Achievement for Every Student
parent engagement(Describe your activities which engage parents)
Parent Teacher Association (PTA)# of parents involved: ______
How often do they meet? ______/ Open House
Title I Parents’ Night
Adult Literacy Courses
Parent Teacher Organization (PTO)
# of parents involved: ______
How often do they meet? ______/ Adult GED Courses
Adult Outreach
Adult Education
Other parent group: ______
# of parents involved: ______
How often do they meet? ______/ Parenting Programs
Parent Resource Room
Parent Newsletter
Parent Appreciation Night / Fundraisers
Required Parent Conferences
Community Celebrations (e.g. MLK dinner) / Other: ______
Other: ______
Comments: ______
Community/business PARTNERS (Please list ALL of your school’s community and business partners)
Partner Name / Program/ Service Provided / Donation/Resource1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Comments: ______
Facilitator’s Name ______pg. 1 of 10