MMGWLogo 2016 MMGW Surveys Order Form
    
 Administration Window: January 25 to February 19, 2016  


About the Surveys: The MMGW Student Survey will be administered to all eighth-grade students in the school or a random sample of 100 or more eighth-grade students. The MMGW Teacher Survey will be administered to all teachers grades six to eight in your building. The administration window for both surveys will be January 25 to February 19, 2016. Participating schools will receive a school-level report by June 2016. The cost is $450.

In 2016, SREB is offering an optional correlation report in addition to the student and teacher surveys. This report will provide schools with student survey results correlated to their state assessment results. Sites that opt in must provide SREB with state test data for students who participate in the survey. In return, sites will receive a report detailing average scale scores and proficiency ratings correlated with several areas of the MMGW Student Survey that address school and classroom practices and academic support. This report will arrive separately from the MMGW Student and Teacher Survey results. The time sent will vary based on when your state's assessment data are released and when SREB receives your roster form. The cost of this report is $500. An Excel file of student responses by ID number is also available for $100.

Instructions:  A paper order form is available  and can be used to collect necessary information before placing your order online. Orders must be submitted online. All requested information is required for your order to be processed. Please note that schools should follow their MMGW state coordinator’s instructions for ordering the surveys.

Contact: If you have any questions about this order form, need to submit a change after an order has been placed, need to send a purchase order, or have questions about the assessment, please contact Chris Fuga by email at chris.fuga@sreb.org, by phone at (404) 879-5556, by fax at (404) 872-1477 or by mail at Southern Regional Education Board, 592 10th Street, N.W., Atlanta, GA, 30318-5776.

Ohio schools order via your Regional HSTW office.  Do not order online.

* 1. Has your school previously participated in the Middle Grades Assessment or MMGW Surveys administered in even-numbered years?

*  2. Official School Name:

*  3. Contact Person (person in the school building who will receive all materials and communications):
       Name
       Phone (xxx-xxx-xxxx)     
       Email Address  
       School Shipping/Street Address (Do not use P.O. boxes)
       City
       State  Ohio - order via your Regional HSTW Office. Do not order online.
      Zip Code

*  4. Principal:
     
       Name
       Phone (xxx-xxx-xxxx)     
       Email Address  

*  5. Person Placing Order:
     
       Name
       Phone (xxx-xxx-xxxx)     
       Email Address  

*  6. Total Number of Students Your School Plans to Survey:*   
*Schools must survey at least 100 students or all students if the 8th-grade class has fewer than 100 students

Select one of the following sampling options to indicate how your school will identify participants.*
*Schools with a contract with SREB should use the number of students and sampling method specified in their contract.


   7. Costs
 Please select if you will participate in further research options. More information is available on our website.

$450  for the MMGW Student and Teacher Surveys per school. The number of students and teachers surveyed does not affect price.

 $500  for the optional MMGW Correlation Report (linking student responses on the 2016  MMGW Student Survey to their subsequent scores on the state assessments).

 $100 for the Optional Excel  file with survey results.

Total Cost: $450

 

 *8. Payment Information: If your school or district is paying for part or all of the surveys, a copy of your purchase order (P.O.) must be received by SREB by December 4, 2015  to confirm your order. Final payment is due to SREB by April 30, 2016. Please indicate how your school will pay for the surveys. (Select all that apply.)

     $ P.O. Number:  
     $ P.O. Number:  
     $  
     $    
     $ Please explain:  

    The cost entered is $0

    School or District Billing Information: If your school or district is paying for part or all of the surveys, please provide the following billing information.

     Name   

     Phone     

     Email Address     

     Office/District/Agency Name   

     Mailing Address   

     City   

     State   

     Zip Code       

 * 9. Teacher Survey: Please indicate the number of full- and part-time teaching staff in grades six to eight in your building. Do not include non-teaching staff (e.g., administrators, media specialists, guidance counselors, custodians, etc.).
     Number of Teachers: 
 
 * 10. MMGW Surveys Participation Agreement: By submitting this order, our school understands and agrees to the following:
  • We will be responsible for paying a $100 cancellation fee should we cancel our order after the survey window has begun.
  • Unless we are surveying all eighth-grade students, we will select a true random sample of eighth-grade students to participate using the random sampling instructions provided.
  • We will ensure full payment arrives at SREB by April 30, 2016 .

          Name of authorizing individual:    
          Title of authorizing individual:   

Please click here to submit your order. After clicking submit, if you are not redirected to a confirmation page, your order has not been submitted. Please make sure you have completed all required fields. Please do not click the back arrow on your browser after submitting your order.