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Part A - Respondent Information

  • Please identify your school by Name, Level, and District, and provide all contact information for the individual who responded to this survey.
  • Report current information.
  • Complete a separate questionnaire for each school.
  • Do not combine data for multiple schools in one survey.

Our Example school, in Clean Water, IA, has 2 media centers in the building.  Both media centers will be included in the report for this building.  Exception: If the building houses 2 separate schools, identified as separate schools each with an ID number in the Department of Education directory, the media center for each school would complete a separate survey.  One example is Columbus Junction, where the High School and the Middle School are at the same address but have different Codes.

Our library media specialist, Tread Water, manages a total of 3 school library media centers including the ones at Example school.  This report will be only for Example.  

The LMCs in the other 2 buildings will be reported separately.

AEA Name     Helpful AEA 

AEA #  25

School Name   Example

School Level (Mark one)  Elementary   Jr. High/Middle   High   Combined

Grades in school (circle all that apply) Pre-K 1 2 3 4 5 6 7 8 9 10 11 12

District Name   Rural

School Address    RR 5

County   Clean Air

City   Clean Water

Zip code   12345

The number of Library Media Centers you manage in your building: 2

The number of Library Media Centers you manage in your district: 3

Name of Respondent   Tread Water

Title: LMS Coordinator

Three ways to contact the respondent:

Phone (515 )123-1234

Fax (515 )123-1234

e-Mail   tw@blazingfast.net

FAQ for Respondent Information:

Should a district library complete a survey?

If the district library has a library media program, a collection, and a media staff, it is appropriate for the district to complete the survey.

Do AEA Media Centers complete the survey?

No.

Our LMC serves both the Middle School and the High School in the same building.  Do I do 1 survey?

Yes.


Last modified March 28, 2006 08:47 PM