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OETT Professional Learning Communities Survey
School and Teacher Information
*
Please enter the last four (4) digits of your SSN:
Please enter the last four (4) digits of your SSN:
*
Gender:
Gender:
Male
Female
*
School Name:
(Choose one from drop-down menu.)
Agra High School
Bishop Public Schools
Haskell Middle School
Spring Creek Elementary
Rose Witcher Elementary
Garber Public Schools
Kansas Middle School
Keota Public Schools
Mangum High School
Mustang Elementary
Central Elementary
Snyder Elementary
Terral Public Schools
Warner Elementary
Yarbrough High School
School Name: (Choose one from drop-down menu.)
*
School District:
(Choose one from drop-down menu.)
Agra
Bishop
Broken Arrow
El Reno
Garber
Kansas
Keota
Mangum
Mustang
Putnam City
Snyder
Terral
Warner
Yarbrough
School District: (Choose one from drop-down menu.)
*
Grades you teach:
(Please choose range which is most appropriate.)
Grades you teach: (Please choose range which is most appropriate.)
PK-2
3-5
K-6
6-8 (Middle School)
7-9 (Junior High School)
9-12
PK-12
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Subject or Assignment:
(Please choose your primary assignment.)
Subject or Assignment: (Please choose your primary assignment.)
Administrator
Business
Computers
Counselor
Elementary(Pre-K through grade 6)
Family and Consumer Science
Fine Arts
Foreign Language
Language Arts/English
Library/Media
Mathematics
Physical Education/Health
Reading
Science
Social Studies
Special Education
Technology
Vocational Agriculture
Other (specify below)
Other (please specify)
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Self-Contained:
Self-Contained:
Yes
No
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Years employed as a teacher:
Years employed as a teacher:
*
Years employed at your school:
Years employed at your school:
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