While in high school you took a [CEP Name] course for ...
1. I graduated from
High School
City/State
If different, I took [CEP Name] course(s) at the following location:
High School or Career Center
City/State
2. The number of [Postsecondary Institution Name] college credits I earned by taking [CEP Name] courses is .
3. I would rate my overall experience with [CEP Name]:
o Excellent
o Good
o Neutral
o Poor
o Very Poor
|I took [CEP Name] courses in the following discipline(s): (Check all that apply) |
|Humanities & Social Sciences |Mathematics & Sciences |Career and Technical |
|Communication |Biology |Agriculture, Food, and Natural Resources |
|College Success Skills |Chemistry |Architecture |
|Economics |Environmental Science |Automotive |
|English & Composition |Mathematics |Business |
|Foreign Languages |Physics |Computer Science/Information Technology |
|Government |Other |Construction Trades |
|History | |Engineering/Engineering Technology |
|Psychology | |Journalism/Communications Technology |
|Visual & Performing Arts | |Manufacturing/Industrial Technology |
|Other | |Medical/Health Sciences |
| | |Teacher Education |
| | |Other |
|Please describe what you are currently doing (select only one option) | |
| |The highest degree or certificate I |
| |eventually plan to obtain is a: |
| |I am not currently continuing my education. I am | |
|I am continuing my education in a: | | |
|Career School or College, or an Apprenticeship |Serving in the Military or other National Service |High School Diploma or Equivalent |
|Program | | |
|Public 2-Year Community or Technical College |Employed Part-time, Full-time, or Self-Employed |Technical Certificate or Diploma |
|Private 2-Year Community or Technical College |Caring for a Home/Family |Associate's Degree |
|Public 4-Year College or University |Unemployed |Bachelor's Degree |
|Private 4-Year College or University |Other |Graduate Degree |
Yes No
7. I would recommend [CEP Name] courses to current high school students o o
|By taking the [CEP Name] course(s), I: |Strongly | | | |Strongly |
| |Agree |Agree |Neutral |Disagree |Disagree |
|Was better prepared academically for college |o |o |o |o |o |
|Developed more realistic expectations about college |o |o |o |o |o |
|Was more confident about my ability to succeed in college |o |o |o |o |o |
|Considered, for the first time, enrolling in college |o |o |o |o |o |
|Improved my study skills |o |o |o |o |o |
|Improved my time management skills |o |o |o |o |o |
If you are not currently continuing your education, please skip to question 14.
9. I am currently enrolled in postsecondary coursework at:
Name: City/State:
| |Yes |No |
|I qualified for a Pell Grant for college |o |o |
|The [CEP Name] course(s) was/were at least as challenging as the courses I enrolled in at my current |o |o |
|college or university | | |
|I attempted to transfer some or all of the [Postsecondary Institution Name] credits I earned through |o |o |
|[CEP Name] to my current college or university | | |
|I was able to successfully transfer some or all of the [Postsecondary Institution Name] credits I |o |o |
|earned through [CEP Name] to my current college or university | | |
If yes, the credits: (Check all that apply)
o Enabled me to enroll in a more advanced course
o Exempted me from a required course
o Counted as credit toward my college degree completion
o Other:
[pic]
The next few questions may seem personal. We ask these questions because governmental and education-related agencies often want to know who is served by [CEP Name].
10. I am:
o Female
o Male
11. Do you consider yourself Hispanic or Latino?
o Yes
o No
12. Which category best describes your race? (Check all that apply)
o American Indian or Alaska Native
o Asian
o Black or African American
o Native Hawaiian or Other Pacific Islander
o White
o Decline Response
13. To the best of my knowledge, the highest education level achieved by at least one of my parents is:
o High School Not Completed
o High School Diploma or Equivalent
o Some College-Level Work Completed
o Technical Certificate or Diploma
o Associate's Degree
o Bachelor's Degree
o Graduate Degree
o Do not know
14. While in high school, I was eligible for the Free/Reduced Price Lunch Program:
o Yes
o No
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