1. Title of class ________________________ Grade _________

2. Gender _____________ Ethnicity ___________________ Age ________

3. How many years have you attended school in the United States? _________

4. Are you currently enrolled in any classes that are "ELD," "Sheltered," or "SDAIE"?

(Circle one) yes / no

5. Have you ever been enrolled in any class that is "ELD," "Sheltered," or "SDAIE"?

(Circle one) yes / no

6. Estimate the number of hours you have spent in school preparing for the test:

(Circle one) 0 hrs / 1-5 hrs / 6-10 hrs / 11-15 hrs / more than 15 hrs

7. "Your performance on this test affects your future."

(Circle one) strongly agree / agree / not sure / disagree / strongly disagree

8. "This test measures how smart you are."

(Circle one) strongly agree / agree / not sure / disagree / strongly disagree

9. "When I took the test, I understood what the questions, answers, and directions."

(Circle one) strongly agree / agree / not sure / disagree / strongly disagree

10. "This test measures what I learn in my classes."

(Circle one) strongly agree / agree / not sure / disagree / strongly disagree

***On the back of this sheet, please write down your thoughts about this test. This can include questions you have, opinions you want heard, or suggestions you want to make.