HSSSE 2009-2010 Interest

Thank you for your interest in the High School Survey of Student Engagement (HSSSE).

To receive additional information about HSSSE, please fill out the following information and click "Submit." This WILL NOT register your school for HSSSE 2009-2010.

You can also contact HSSSE staff members directly at 812-856-1429 or at hssse@indiana.edu.

School Information
Formal School Name:
City :
State:
Total High School Enrollment:

Contact Information
Prefix:
First Name:
Last Name:
Street Address:
City:
State:
ZIP+4 Code:	(e.g., 47401-3654)
Phone:	(e.g., 812-856-1429)
Extension:
E-mail Address:	(Provide an e-mail address that can receive external and group e-mails.)
E-mail Address:	(Please confirm your email address)

General Information
Please tell us a bit about yourself. Are you a:	Superintendent Principal Administrator Teacher College/University Educator Researcher Student Other:
Please describe your interest in HSSSE and any specific questions you have:
When are you interested in administering the survey?	Fall 2009 Spring 2010 Fall 2009 and Spring 2010
How did you hear about HSSSE? (check all that apply)	School Administrators Conference/Presentation - Where? Mailing HSSSE website Media - specify Other:

If you have any technical problems using this site, please e-mail (

) or call 812.856.1429.