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.
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AEA Name Helpful AEA |
AEA # 25 |
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School Name Example |
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School Level (Mark one) Elementary Jr. High/Middle High Combined |
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Grades in school (circle all that apply) Pre-K 1 2 3 4 5 6 7 8 9 10 11 12 |
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District Name Rural |
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School Address RR 5 |
County Clean Air |
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City Clean Water |
Zip code 12345 |
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The number of Library Media Centers you manage in your building: 2 |
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The number of Library Media Centers you manage in your district: 3 |
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Name of Respondent Tread Water |
Title: LMS Coordinator |
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Three ways to contact the respondent: |
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Phone (515 )123-1234 |
Fax (515 )123-1234 |
e-Mail tw@blazingfast.net |
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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.