Sample Staff, Parent, and Student Survey Template

Use this tool to develop a survey instrument to gather basic perceptual data related to the Correlates of Effective Schools. These correlates serve as a conceptual framework for looking at research-correlated elements of the effective school. Because perceptions may change as the school adjusts or implements new programs, the surveys should be administered from time to time to measure the impact of the continuous improvement process.

General Directions for the use of the survey templates:

  1. Brainstorm 2-4 additional questions under each correlate that will give you the information you need to accurately define the current situation at your school*.
  2. Develop a plan to distribute and collect the surveys from each of the three suggested stakeholder groups (students, staff, and parents).
  3. Distribute the surveys.
  4. Collect and tabulate the data. The surveys may be able to set up either on-line or using a generic bubble sheet to ease in tabulation and analysis.
  5. Summarize the data in chart form, and develop a report for inclusion in the School Profile and other appropriate distribution.
  6. The CIP Team discusses the implications of the data and develops a plan to discuss the results with the broader group of stakeholders.

*The sample survey questions were taken from Reality Check, an online survey tool developed by Effective Schools Products, Inc.

Staff Survey

Instructions: Please think carefully about the following descriptions of school conditions and rate your school based upon your agreement with the statement.

Demographic Information
Gender / Male Female
Years in this School / __0-3 __ 4-6 __ 7-9 __ 10+

SA= Strongly Agree

A= Agree

U= Undecided

D= Disagree

SD= Strongly Disagree

NA= Not Applicable or No Opinions

Safe & Orderly Environment
Dealing with discipline problems in my classroom uses a lot of instructional time. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
High Expectations for Success
Our school staff communicates the belief that all children can learn. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Instructional Leadership
The principal has established a strong academic focus in the school. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Home-School Relations
There is a strong program for parent participation and support of the school’s programs. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Clear and Focused Mission
I have a clear understanding and commitment to the overall purpose and priorities of the school. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Opportunity to Learn/Time on Task
All necessary supplies and materials for basic skills instruction are available to me. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Frequent Monitoring of Student Progress
The standardized tests we administer provide useful information about student performance. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA

Parent Survey

Instructions: Please think carefully about the following descriptions of school conditions and rate your school based upon your agreement with the statement.

Demographic Information
Gender / Male Female
Race/Ethnicity / __White __Hispanic __Asian __African __Native American __ Other Races

SA= Strongly Agree

A= Agree

U= Undecided

D= Disagree

SD= Strongly Disagree

NA= Not Applicable or No Opinions

Safe & Orderly Environment
Teachers at this school really care about the students. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
High Expectations for Success
This school has high academic standards for all students. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Instructional Leadership
The principal communicates well with parents about the school’s instructional program. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Home-School Relations
A parent-school organization exists and is inviting to all parents and has proven to be an effective group. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Clear and Focused Mission
The subjects taught to my child in school are important ones for their future. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Opportunity to Learn/Time on Task
Teachers in the school use their classroom time very effectively, with little wasted time. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Frequent Monitoring of Student Progress
Teachers give my child prompt and specific feedback o the quality of their classroom work. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA

Student Survey

Instructions: Please think carefully about the following descriptions of school conditions and rate your school based upon your agreement with the statement.

Demographic Information
Gender / Male Female
Grade Level / __9th __ 10th __ 11th __ 12th

SA= Strongly Agree

A= Agree

U= Undecided

D= Disagree

SD= Strongly Disagree

NA= Not Applicable or No Opinions

Safe & Orderly Environment
I feel safe at school. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
High Expectations for Success
My teachers expect me to get good grades on assigned work and tests. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Instructional Leadership
It is easy for me to get to see the principal or another administrator face-to-face. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Home-School Relations
Meaningful and appropriate amounts of homework is assigned on a frequent basis. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Clear and Focused Mission
The subjects I learn about in school are the important ones. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Opportunity to Learn/Time on Task
Teachers start class on time and use the full class time for teaching and learning. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA
Frequent Monitoring of Student Progress
My teachers grade my work and return it to me on a timely basis. / SA A U UD SD NA
SA A U UD SD NA
SA A U UD SD NA