Sample Needs Assessment Survey Template

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Sample Three
SAMPLE NEEDS ASSESSMENT SURVEY
This needs assessment should be filled out by the school principal with input from teachers.
Part A: Staffing
1.
Indicate the number of teachers in the following areas:
Science______
Math______
Reading______
2.
Indicate the number of teachers who are certified for the position they are in:
Science______
Math______
Reading______
3.
Is there an adequate supply of teachers?
Math yes no
Science yes no
Reading yes no
4.
On the basis of questions 1-3, the greatest need for assistance for our teachers is:
CHECK ONE
Math
Science
Reading
____No needs
____No needs
____No needs
____Need for in-service
____Need for in-service
____Need for in-service
____Need to retrain teachers
____Need to retrain teachers
____Need to retrain teachers
from other fields
from other fields
from other fields
____Need for more teachers
____Need for more teachers
____Need for more teachers
in this field
in this field
in this field
Part B: Professional Development
Please prioritize the teacher training items listed below by numbering 1-5 with 1 being the highest priority, 2 second highest, and so on.
Mathematics
Science
____New methods of instruction
____New methods of instruction
____New content information (curriculum)
____New content information (curriculum)
____Increased knowledge of technology
____Increased knowledge of technology
____Current trends in mathematics
____Current trends in science
____Innovative programs
____Innovative programs
Language Arts/Reading
Social Studies
____New methods of instruction
____New methods of instruction
____New content information (curriculum)
____New content information (curriculum)
____Increased knowledge of technology
____Increased knowledge of technology
____Current trends in language arts/reading
____Current trends in social studies
____Innovative programs
____Innovative programs
Part C: Accessibility of Programs
Do the following groups have equal access to do the programs listed below? Circle Y – yes or N – no
Math
Science
Lang. Arts
Soc. Studies
Minorities
Y N
Y N
Y N
Y N
Economically Disadvantaged
Y N
Y N
Y N
Y N
Girls and Women
Y N
Y N
Y N
Y N
Disabled
Y N
Y N
Y N
Y N
LEP students
Y N
Y N
Y N
Y N
School__________________________________________________________________

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