
Developed as part of:
American Institutes for Research1998
1000 Thomas Jefferson Street, N.W.
Suite 400
Washington, D.C. 20007
(202) 944-5300
Rita Kirshstein, Project Director
Please provide the following information:
Name of the school _____________________________________________________________
School address ________________________________________________________________
School phone number __________________________________________________________
| ___ | Elementary (includes at least grades 1-4) |
| ___ | Middle/Intermediate/Junior (includes no grade below 4 or above 10, but includes at least grade 7-8) |
| ___ | High/includes at least grade 11 and 12) |
| ___ | Combined (combination of one or more of the above categories) |
a. For staff/administrative use only (no student access) ____________
b. For student use (include any used by students,
even if staff members also use them) ____________
c. Other (please specify____________) ____________
d. Total (should equal the sum of a, b, and c) ____________
a. Classrooms/Instructional rooms _____________
b. Libraries/Media Centers _____________
c. Computer labs _____________
d. Staff/administrative offices _____________
e. Other (please specify _____________) _____________
f. Total (should equal the sum of a through e) _____________
a. IBM-compatible 286 ___________
b. IBM-compatible 386 ___________
c. IBM-compatible 486 ___________
d. IBM-compatible Pentium ___________
e. Other IBM-compatible ___________
f. Apple II ___________
g. Macintosh ___________
h. Power Mac ___________
i. LC 475/LC 580 ___________
j. Other Apple or Macintosh clone ___________
k. Total (should equal #5b above) ___________
a. CD-ROM drive/DVD drive _____________
b. Microphone _____________
c. Speakers _____________
d. Interactive videodisc player _____________
e. Video camera _____________
f. Scanner _____________
g. Printer _____________
h. Other (please specify _______________) _____________
Other (please specify _______________) _____________
Other (please specify _______________) _____________
a.___Word processing
b.___Spreadsheet
c.___Database
d.___Graphical
e.___Desktop publishing
f.___Presentations
g.___On-line services (e.g., America Online, CompuServe, KidsNet, or Prodigy)
h.___Hypermedia/Multimedia (e.g., Hypercard)
i.___Integrated Learning Systems (e.g., Jostens, CCC)
j.___Simulation Programs
k.___Drill/Practice Programs/Tutorials
l.___Other (please specify ___________________)
___Yes, full-time
___Yes, part-time
___No
___None
___1
___2-3
___4 or more
___Yes
___No
___Yes
___No (SKIP TO Q. 20)
___Yes, as a tool for learning
___Yes, as a separate subject
___Yes, both
___No
___Yes, for teachers only
___Yes, for students only
___Yes, for both teachers and students
___No