APPENDIX P_CPTED Student Survey Make-Up List_OMB_110410

APPENDIX P

CPTED Student Survey Make-Up List

CRIME PREVENTION THROUGH ENVIRONMENTAL DESIGN (CPTED) STUDENT SURVEY MAKE-UP LIST
School Name: _______________________________			Teacher Name(s):_______________________________ Class: __________________________Period:_______ Grades(s): _____
Dear Teacher: Students who are eligible to participate but did NOT complete the CPTED Student Survey on the designated administration day are listed on the make-up list below. Schools using active parental permission forms please note—Any students coded as NFR (No Form Returned) must have returned a signed parental permission form, with the “yes” box checked, to be surveyed as part of a make-up session. Within 2 weeks of the initial data collection of your class, please conduct a small group make-up survey administration with the students listed below. An adequate supply of survey booklets and pencils is enclosed. When administering the survey, please follow the enclosed make-up instruction guide closely. Place a check mark next to each student completing a makeup. For any student(s) not completing a make-up survey, please note the reason (if known) next to the student’s name below. Please return any unused survey booklets. Please do NOT send back pencils. When you have completed the make-ups, please place each student’s survey in the white, business reply, pre-paid envelope marked MAKE-UPS along with this form. Please verify that your name, school name, and class information is written on the envelope prior to mailing. Important: If a student for all practical purposes has ceased to come to class or attend school and you cannot conduct a make-up, mark a capital “D” next to his/her name. Thank you again for your help. If you have any questions, please call us toll-free at 1-XXX-XXX-XXXX or email CPTEDstudy@icfi.com. PLEASE PRINT NAMES (OR IDENTIFIER) CLEARLY.
Males Needing Make-ups	Eligibility Code	Females Needing Make-ups		Eligibility Code