GRADE 8

GRADE 8

VIDEOTAPE I.D. #:                      

TIMSS-R Video  Study

James Stigler- Study Director

12436 Santa Monica Blvd.

Los Angeles, CA  90025

According to the paperwork reduction act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information is __________.  The time required to complete this information collection is estimated to average 12 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collected.  If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:  U.S. Department of Education, Washington, D.C. 20202-4651.  If you have comments or concerns regarding the status of your individual submission of this form, write directly to: National Center for Education Statistics, 555 New Jersey Avenue, N.W., Washington, D.C. 20208.

TIMSS-R

Videotape Classroom Study

STUDENT QUESTIONNAIRE

Thank you for participating in this study.  Both the videotape and the questionnaire will be used only for research purposes, unless you have signed an agreement that states otherwise. All persons with access to this information will be licensed to protect your privacy.

Thank you for your careful attention to this questionnaire.  We appreciate the time you are taking to help us better understand mathematics teaching. 

School’s Name: __________________________________________________________

1.                  On what date were you born?

Write in the month, day, and year

(DAY, MONTH, & YEAR FORMAT TO BE USED IN OTHER NATIONS)

___  ___  MONTH ___  ___  DAY  ___  ___  ___  ___  YEAR

2.                  Are you a girl or a boy?

Circle either A or B.

Girl………………..A

Boy………………..B

3.                  Which best describes you? (U.S. VERSION. COUNTRY CHOICES WILL VARY).)

What is your ethnicity?

Hispanic or Latino ……………………………A           

Not Hispanic or Latino………………………. B

What is your race?

(Choose one or more)

American Indian or Alaska Native…………….C

Asian…………………………………………. D           

Black or African American……………………E

Native Hawaiian or Other Pacific Islander……F

White………………………………………….G

4.                  Were you born in the United States or its territories (such as Puerto Rico, U.S. Virgin Islands)? (U.S. VERSION. COUNTRY NAME WILL VARY).

Circle either A or B

Yes……………..A

No………………B

5.                  If you were not born in United States or its territories (such as Puerto Rico, U.S. Virgin Islands), how old were you when you came to the United States?

                        Write in your age at the time.

            I was __________ years old when I came to the United States.

                                                (U.S. VERSION. COUNTRY NAME WILL VARY).

6.                  How often do you speak English at home?

            Circle one of the following. (U.S. VERSION. NATIONAL LANGUAGE WILL VARY).

Always or almost always…………..A

About half of the time……………...B         

Rarely or never ……………………C

7.         Altogether, how many people live in your home?

            Write in total number of people.

            __________ (Don’t forget to include yourself.)

8.         How far in school did your mother and father go?

                        Circle ONE letter in each column

                                                                                                                  Mother        Father

a.  Finished elementary school……………………………………………. A            ..A

b.  Some high school……………………………………………………… B             ..B

c.  Finished high school…………………………………………………… C            ..C

d.  Some vocational/technical school after high school……………………D             ..D

e.  Some community college or university course work…………………...E              ..E

f.  Completed a bachelor’s degree at college or    university……………....F             ..F

g.  I don’t know…………………………………………………………….G           ..G

9.                  How far in school do you expect to go?

10.              Was your mother born in the United States or its territories (such as Puerto Rico, U.S. Virgin Islands)? (U.S. VERSION. COUNTRY NAME WILL VARY).

Circle either A or B

            Yes……………..A

No………………B

11.              Was your father born in the United States or its territories (such as Puerto Rico, U.S. Virgin Islands)?  (U.S. VERSION. COUNTRY NAME WILL VARY).

Circle either A or B

Yes……………..A

No………………B

12.              About how many books are in your home?  (Do not count magazines, newspapers, or your schoolbooks).  Circle only one letter A-E

None or very few  (1-10 books)…………………………………………...A

Enough to fill one shelf (11-25 books)…………………………………….B

Enough to fill one bookcase (26-100 books)……………………………....C

Enough to fill two bookcase (101-200 books……………………………...D

Enough t fill three or more bookcases (more than 200 books)…………….E

Thank you!