Pennsylvania 21st CCLC grantees are required to collect a completed Teacher Survey for each student in grades 1-5 who attends the 21st Century program. A math or reading/language arts teacher is recommended.  

Grantees and teachers must use the provided Teacher Survey content, as it is aligned to grantee reporting elements. The Teacher Survey should be administered in the spring, as close to the end of the school year program as possible in order to capture a student's growth over the course of the school year.

21st Century Teacher Survey Form - Fillable PDF [Updated June 2023]

21st Century Teacher Survey Form - Word Doc [Updated June 2023]

Choose the PDF version to administer the survey online through email. Choose the Word doc version to complete/administer the survey on paper. If the teacher chooses to use the paper version, they should return the completed survey to the grantee/program. Do not send individual surveys to AIU Evaluators.

The AIU still offers grantees the option for an online teacher survey; however, we have changed how we are structuring this to allow grantees faster and more efficient access to their survey data.  If you are interested in using the AIU's online 21st Century Teacher Survey, please contact Falon Weidman for details and links.  

The AIU's web-based 21st Century Teacher Survey is for use only by Pennsylvania 21st Century grantees and the schools they serve. This service is not currently available to other states.

Individual student survey data is protected by a restricted access system and provided to the primary contact of each grantee.   

AIU offers the web-based Teacher Survey to 21st CCLC grantees free-of-charge as a convenience option. Grantees are not obligated to use this service. 

Questions? Contact Falon Weidman or 412-394-1347.