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PRO-ED is seeking assessment professionals to participate
in upcoming test standardizations. Your participation in such studies can help
us maintain the high quality standards of PRO-ED assessment instruments.
Details of any particular study will be specified when it is sent to you for
your consideration. Completion and submission of this form does not commit you
to participation in future studies.
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| * Denotes required field |
| First Name: |
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| Last Name: |
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| Position or Title: |
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| Agency or Affiliation: |
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| Address Line 1: |
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| Address Line 2: |
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| City: |
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| State: |
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| ZIP Code: |
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| Work Phone: |
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| Other Phone: |
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| Your E-mail Address: |
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| 1. In which of the following areas might you or your staff
consider participating for future test tryouts or standardizations? (Check all
that apply) |
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| 2. Which of the following are represented on your staff? (Check
all that apply) |
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| 3. Which of the following best describes your place of
employment? (Check all that apply)
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| 4. The percentage of individuals you evaluate who are:
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| 5. Do you have access to: |
| Normally developing children?
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Normal adults?
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| 6. What ages are you able to test?
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| 7. Do you have access to individuals with any of the following
types of special needs? (Please check all that apply)
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| 8. The percentage of individuals you evaluate who are: |
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| 9. Regardless of race, what percentage of the clients you
assess are of Hispanic origin?
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| 10. Among the Hispanic clients, approximately what percentage do
NOT speak English proficiently?
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| 11. What is the approximate size of the communities you serve?
(Check all that apply) |
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| 12. What percentage of your clients are in the following income
brackets?
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| 13. How did you hear about PRO-ED field testing? |
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Other:
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| Additional Comments or Questions : |
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