1. PACT Demographic Survey

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* 1. Your Candidate ID number:
(Please use the same ID number that was used to identify your Teaching Event.
If you use G*STAR or UCOPIS, use the number assigned to you in the electronic platform.)

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* 2. Check the institution at which you are earning your credential:

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* 3. Check the content area for which you completed the Teaching Event: (Check one only)

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* Questions 4-5 are needed for analyses of the Teaching Event to meet Program Standard 19g

4. Your gender:

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* 5. How do you prefer to identify yourself?
(Check as many as apply)

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* 6. What is the highest degree you hold?

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* 7. What is your primary language?

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* 8. Are you currently (Check one):

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* 9. What type of credential are you working toward?

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* Answer questions 10-14 with respect to the class in which you completed the Teaching Event.

10. In what grade level were most of the students in your class? (If students were from multiple grade levels, select the one in which most students fell.)

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* 11. How would you describe the community from which most of your students come?

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* 12. Approximately what percentage of your students are eligible for free or reduced lunch?

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* 13. How would you characterize most of your class with respect to achievement related to student content standards for the content area or course you are teaching?

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* 14. Complete the following table with the number of students in each category:
Use numerals, not words.

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* 15. During your student/intern teaching for the Teaching Event, which, if any, of the following influenced your instructional planning?
(Check all that apply)

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