Survey Non-Participant Form | Wyoming Department of Education

Student Survey Non-Participant Form

Instructions

In order to ensure participation rates are calculated correctly, please provide the following information for any student who was enrolled based on the Fall WDE684 and did NOT participate in the student climate survey. If ALL students who were enrolled on or before October 1, 2019 participated in the climate survey, do not complete this form. This form must be submitted by November 27, 2019. If you have questions, please contact Susan Williams at susan.williams@wyo.gov.

District Name: *

School Name: *

Name of person filling out this form: *

Email address: *

Student Information

Please fill in the information for every student that did not participate. Click "add" to input information for additional students who did not complete the student climate survey.

Student WISER ID: *

Reason for non-participation: *

Student exited on or before November 19, 2019 (must be reported as exited prior to this date on the WDE684)

Student is placed elsewhere

Student is a virtual education student (must be based on approved definition under W.S. 21-12-330(f)(v))

Student is expelled but receiving services

Student is homebound (must be based on approved definition under W.S. 21-4-402(a))

Please provide the name of the institution where the student is placed. *

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