**DRAFT – 2/9/00**

Archived Information

**STUDENT #:  _______________**

**SURVEY OF GEAR UP PARTICIPANTS**

**(Middle School Grades)**

**A.SCHOOL AND SCHOOL WORK**

1.Who usually helps you with your homework?**YesNo**

A teacher at your school((

A GEAR UP tutor((

A GEAR UP mentor((

Your mother, father or guardian((

Another adult in your home((

Your brother or sister((

A classmate or friend((

Some other person 

Who? ((

2.Compared with other students, how hard do you think you work in school?

Much harder(

Harder(

About the same(

Not as hard(

Much less hard(

3.What type of student do you consider yourself?

Excellent(

Good(

Fair(

Poor(

4.How important to you is what each of the following people think you should do about your education?  (CHECK ONE BOX IN EACH ROW)

**NotSomewhatVery**

**importantimportantimportant**

Parent(s) or Guardian(s)(((

Teacher(s) (((

Guidance Counselor (s)(((

Principal or Assistant Principal(((

Religious leader (minister, priest, rabbi, etc.)(((

Friend(s) (((

Coach(((

GEAR UP staff (mentors, tutors, staff, etc.)(((

Some other person

Who?(((

###### B.KNOWLEDGE ABOUT COLLEGE

5.Have you talked with your school counselor or someone else at your school about the entrance requirements for college?

Yes(

No(

6.Do you have an idea of what courses you should take in high school to prepare you for college?

Yes(

No(

7.Have you heard of the following types of postsecondary schools?  

**YesNo**

2-year or community college((

4-year college or university((

Vocational, trade or business school((

Other school

(Describe) ((

8.How much do you think it costs to attend a 4-year public college in your state for one year?

9.How important to your future is getting an education beyond high school?

Very important(

Somewhat important(

Not important(

Don’t know(

10.Do you think a person with a college degree earns more money in year than a person who does not have a college degree?

Yes(

No(

Don’t know(

###### C.PLANS FOR THE FUTURE

11.Do you think you will continue your education after high school (that is, go to college or attend a trade school, etc.)?

Yes(

No(

Not Sure(

12.From whom do you get most of your information about your options for continuing your education after high school?  

Parent(s) or Guardian(s)(

Brother(s) or sister(s)(

Guidance Counselor(

Teacher(s) (

Principal or Assistant Principal(

Religious leader (minister, priest, rabbi, etc.)(

Friend(s) (

An adult in the GEAR UP program(

Someone else

Who?(

13.How far in school do you think you will get after high school?  (CHECK ONLY ONE)

Certificate program (less than 2-year program)(

AA or Associates degree (2-year degree)(

BA or Bachelor’s degree (4-5 year degree)(

Graduate or professional degree (MA, Ph.D., law, MD)(

Don’t know(

14.What is the main reason you would not continue your education after high school? 

(CHECK ONE)

It costs too much or I cannot afford it(

## I need or want to work(

My grades are not good enough(

I’m just not interested(

I want to join the military service(

I want to start a family or I need to take care of my family(

Some other reason.  What reason? (

15.Do you think you will be able to afford to attend a 4-year college or university after high school?

Definitely(

Probably(

Not Sure(

I doubt it(

Definitely not(

###### D.YOUR FAMILY

16.During the past year, have you discussed the academic requirements for attending a 4-year college with any adults in your household? 

Yes(

No(

17.How much education do you think your parent(s) or guardian(s) want you to get?  (CHECK ONE BOX IN EACH COLUMN)

18.Did any of your family members attend or get a college degree?

**YesNoNot Sure**

Mother or female guardian(((

Father or male guardian(((

Brother(s) or sister(s)(((

Grandparent(s)(((

###### E.BACKGROUND

19.Are you . . .

Male? or(

Female?(

20.When were you born? 

|___|___|-|___|___|-|___|___|___|___|

MonthDay Year

21.How do you describe yourself? (CHECK ALL THAT APPLY)

American Indian or Alaska Native(

Asian(

Black or African American(

Hispanic or Latino(

White(

Native Hawaiian or Other Pacific Islander(

Other (Describe) (

###### F.GEAR UP PARTICIPATION 

22.Overall, how much would you say you participate in the GEAR UP program?

Always or Almost always(

Most of the time(

About half the time(

Sometimes(

Never or Almost never(

23.During the past school year, how often did you attend each of the following types of activities provided by the GEAR UP program?

24.Overall, how satisfied are you with the GEAR UP program?

Very Satisfied(

Satisfied(

Dissatisfied(

Very dissatisfied(

25.Are you satisfied with the services you received from the program for each of the following activities?  

26.As part of your participation in the program, have you received a 21st Century Scholar Certificate?  This certificate indicates how much financial assistance you may be eligible to receive from the federal government for college.

Yes(

No(

27.**IF YOU RECEIVED THIS CERTIFICATE**, Has receiving this certificate changed your plans about college?

Yes(

No(

28.Has being in the GEAR UP program changed your plans about going to college?

Yes(

No(

29.**IF THE PROGRAM HAS CHANGED YOUR PLANS**, What was the biggest factor?

Information about financial aid and how much college costs(

Information about the benefits of going to college(

Tutoring or help with school work(

Mentoring(

Visits to college campus(

Other (please explain) _______________(

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