OM B Control No.: xxxx - xxxx Ex piration Date: xx/xx/xxxx

(5 - 31 - 12)



### This survey is authorized by law (xxxx). **We want you to know that: 1.**  **We are**  **asking you**  **these questions**  **in order**  **to gather**  **information about**  **your educational**  **and work experiences. 2.**  **Please be**  **assured that**  **all information**  **you provide**  **will be**  **kept confidential.**  **Using the**  **Login Identification**  **Number and**  **Password ensures**  **that t**  **he information**  **you provide**  **to the**  **study will**  **be protected**  **and will**  **only be**  **seen by**  **s elected**  **members of**  **the study**  **team. The**  **next page**  **provides you**  **with general**  **information about**  **the survey.**  **You may**  **skip any**  **questions you**  **do not**  **wish to**  **answer. Howe**  **ver, we**  **h ope**  **that yo**  **u answer**  **as many questions as you can.**  **As a**  **thank you for participating in the survey, we would like to send you $**  **15 if completed by Web and $10 if completed by phone or paper.**  **For questions, call toll free at ( xxx**  **) xxx**  **- xxx**  **or email xxxxxxx**  **@ yyyyyyyy**  **.com**



## You may complet **e the survey one of three way s:**  **Receive $15 Receive $10**  **Receive $10** COMPLETE SURVEY BY W EB **OR** COMPLETE THIS PAPER SURVEY AND RETURN **OR** CALL XXXX IF YOU W ANT TO BE INTERVIEW ED OVER THE TELEPHONE **Log on at: https://www.**  **xxxxxx .org**  and enter your user ID and password **Mail to:** Xxx Yyyy , Survey Di rector, Survey of Recent Program Applicants Contact info: Use the enclosed pre - addressed postage paid envelope **Call:** Company toll free at: **( xxx**  **) xxx**  **- xxx**  and ask for the S urvey of Recent Program Applicants

Per the policies and procedures required by the Education Sciences Reform Act of 2002, Title I, Part E, Section 183, response s to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a n individual. We will not provide information that identifies you to anyone outside the study team, except as required by law. Any willful disclosure of such information for nonstatistical purposes, without the informed consent of the respondent, is a class E felony. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control nu mber. The valid OMB control number for this information collection is XXXX - XXXX. The time required to complete this information collection is estimated to average 15 minutes per respondent, including the time to rev iew instructions, and complete and review the information collected. 

## BARCODE LABEL 

# Survey **of Recent Program Applicants**

### WHO/WHICH **AG ENCY**  **IS SPONSORING**  **THE STUDY**  **?** This study i s being sponsored by t he U.S. Department of Education. **WHO IS CONDUCTING TH E**  **STUDY?** The study i s being conducted by a team of researchers at XXXX under contract to the U.S. Department of Education. **WHA T**  **IS THE**  **PURPOSE OF**  **THE STUDY?**  Our goal is to learn about how p rogram applicants are doing. It will allow us to understand what works well and what doesn’t. **NO LONGER**  **IN PROGRAM/NEVER**  **PA RTICIPA**  **TE D.**  We a re contacting people who signed up to participate, even if they never attended the educational or training program, or are no longer participating. [ **IF LESS**  **THAN 18**  **YEARS OF**  **AGE :**  The consent form yo ur parents signed me ntioned we would be contacting yo u to conduct an interview.] **HOW DID**  **YOU GET**  **MY NA**  **ME ?**  After you applied to the [PROGRAM at INSTITUTION], and wer e offered yo ur financial aid package, you were scientifically selected from among persons in your program to participate in the study. **I GOT A JOB SOON A**  **FTER I A PPLIED.**  That is wonderful, but we would like to talk to people who didn’t enroll in a program a s well as those who did. **IS THE SURVEY**  **CONFIDENTIA L?**  Yes. Your responses are protected from disclosure by federal statue [P.L. 107 - 347, Title V Confidential Information Protection and Statistical Efficiency Act of 2002 (CIPSEA)]. Your answers will be com bi ned with those of others and yo ur nam e will never be used in reporting the results of the study. Your answers to questions will not affect your eligibility for any public program. [ **I DON’T HA** 

**VE THE TIME. TELEPHONE ONLY:**  We can schedule a call to conduct the survey at yo ur convenience. Our interviewers are available to speak with you seven days a week as follows: on Mondays through Thursdays from 9:00 A 

### . M 

### . to 12:00 mi dnight, on Fridays from 9:00 A 

### . M 

### . to 8:00 P 

### . M 

### . , Saturday s from 9:00 A 

### . M 

### . - 5:00 P 

### . M 

### . and Sundays from 1:00 P 

### . M 

### . to 9:00 P 

### . M 

### . Eastern Standard Time. We can also complete the survey in more than one call, if necessary.] **I’M NOT INTERESTED**  **.** Let me reassure yo u that we are not selling anything. The questions we ask a re designed to help the U.S. Department of Education understand the lives of individuals who applied to participate in a program. There are no right or wr ong answers. We ’re interested in your experiences and opinions. Your answers will be combined with tho se of others and yo ur nam e will never be included in any r eport. We w ill also ma il you a check in the am ount of $15 for com pleting over the W eb or $10 for completing the survey by phone or hard copy. **HOW LONG**  **WILL THIS TA KE?**  The length of the interview var ies, but it usually takes about 15 minutes. **WHO GA** 

**VE YOU**  **THE AUT**  **HORITY TO**  **CONDUCT THE**  **STUDY?** Th is study is being sponsored by t he U.S. Department of Education and has been approved by t he U.S. Office of Management and Budget under OMB control number XXXX - XXXX. Wi thout this approval we would not be able to conduct this survey. Questions regarding any

a spect of this survey may b e directed to U.S. Department of Education, Wa shington, DC 20210, telephone number XXX - XXX - XXXX (this is not a toll - free number) or by email: xxx.xx@ed.gov. **WILL I BE PA ID?**  Yes, we will mail you a check in the amount of $15 for completing over the W eb or $10 for completing the survey by phone or hard copy. The check will be mailed within 2 weeks of completing the survey. **I’M ON**  **THE NA** 

**T IONA**  **L “DO**  **NOT CA**  **LL LIST/REGISTRY.”**  **WHY AR**  **E YOU**  **CA LLING**  **ME ?**  The do not call list or registry applies to telemarketing calls, not to calls like this one that are approved by t he government. Lawmakers recognize the need for the public to participate in studie s like this to learn how government programs are working and how to im prove them. W e will not sell yo u any thing, nor will we ask for money

. Your privacy will be respected, and yo ur cooperation is appreciated. For mo re information on who is included and exc luded on the do not call list, you can visit the website at www.donotcall.gov. **WHO CA**  **N I**  **CONT ACT**  **F O**  **R MORE**  **INFORM AT**  **ION?** For mo re information about the study , you can visit the U.S. Department of Education (ED) website at http://www.ed.gov/. You can also call XXX - XXX - XXXX and ask to speak to [NAME]. 

## FREQUENTLY **AS KED QUESTIONS (FA**  **Qs )** 1

**We received y our name as someone who applied to [fill PROGRAM AT INSTITUTION] in [fill APPLICATION MONTH, YEAR**  **]. T**  **he program may** 

**have informed yo**  **u that yo**  **u were selected to be part of a study for the U.S.**  **Department of Education conducted by**  **[fill COMPANY] .**  **We are contact**  **ing y ou**  **to see how y ou are doing and to learn about some of y**  **our experiences since y**  **ou applied.**  **A1** 

### . **At the time y ou applied to [fill PROGRAM AT INSTITUTION] in [fill APPLICATION MONTH/YEAR], what was the** 

**highest diploma ,**  **degree , or certification**  **yo u had received?**  

### Select one only

**1** 

# □ No diploma, degree, or certificate 2 

# □ Adult basic education (ABE) certificate 3 

# □ General Educational Development (GED) credential or its equivalent
4 

# □ High school diploma
5 

# □ Vocational/technical certificate (less than 2 years) 6 

# □ Associate’s degree ( AS, 2 years)

— vocational
7 

# □ Associate’s degree (AA , 2 years)

— vocational 8 

# □ Bachelor’s degree or equivalent (BA/BS, 4 years) 9 

# □ Master’s degree or equivalent (MA/MS) 10 

# □ Doctoral degree (MD, PhD)
1 1 

# □ Other professional degree/certificate 99 

# □ Other (Specify)

________________________________ ____________________________ **A2. Thinking back**  **to [fill APPLICATION MONTH, YEAR], when y ou applied to [fill PROGRAM AT INSTITUTION], did you** 

**enroll in [fill PROGRAM AT INSTITUTION], enroll in some other educational or training**  **program, or did y ou**  **decide not to enroll in any** 

**educational or training pro grams**  **?** Select one only 1 

# □ Enrolled in [fill PROGRAM AT INSTITUTION] 2 

# □ Enrolled in other educational or training program 3 

# □ D ecided not to enroll in any educational or training programs **GO TO D1, PA GE**  **8** 

### A. **PROGRA M SELECTION** 

**GO TO A3, PAGE 2**2 **A3. Now**  **, we would like to know a bout**  **all of the**  **educational and training program**  **s yo**  **u have enrolled in since [fill APPLICATION MONTH, YEAR].**  **Please complete all of the questions on this table (pages 2 and 3). A.**  **Name of program, institution, city, and state.**  **B. What was/is the field**  **of s**  **tudy? Please use codes**  **below. C**  **. What type of certificate/degree you** 

**expect/expected to receive?** Select one only **D. Program Start**  **and End Date E.**  **Method of**

**Program Delivery** Se lect one only **1.**

_________________________

Name of Program

_________________________ Name of Institution

_________________________

City/State We are interested in the name of the program, not a list of the courses you took within the program. | | | If 99 Other, (Specify)

_____________________ 1 

### □ Vocational/technical certificate (< 2 years) 2 

### □ Associate’s degree ( AS, 2 years , vocational ) 3 

### □ Associate’s degree ( A A , 2 years , academic ) 4 

### □ Bachelor’s degree or equivalent (BA/BS, 4 years) 5 

### □ Master’s degree or equivalent (MA/MS) 6 

### □ Doctoral degree (MD, PhD) 7 

### □ Other professional degree/certificate 99 

### □ Other (Specify) START | | | / | | | | | MONTH YEAR END | | | / | | | | | MONTH YEAR 1 

### □ All in - person 2 

### □ All online (i.e. using a computer without in person instruction) 3 

### □ Some in - person and some online 4 

### □ Some in - person and some at a work/ business location

**2.**

_________________________

Name of Program

_________________________ Name of Institution

_________________________

City/State We are interested in the name of the program, not a list of the courses you took within the program. | | | If 99 Other, (Specify)

_____________________ 1 

### □ Vocational/technical certificate (< 2 years) 2 

### □ Associate’s degree ( AS, 2 years , vocational ) 3 

### □ Associate’s degree ( A A , 2 years , academic ) 4 

### □ Bachelor’s degree or equivalent (BA/BS, 4 years) 5 

### □ Master’s degree or equivalent (MA/MS) 6 

### □ Doctoral degree (MD, PhD) 7 

### □ Other professional degree/certificate 99 

### □ Other (Specify) START | | | / | | | | | MONTH YEAR END | | | / | | | | | MONTH YEAR 1 

### □ All in - person 2 

### □ All online (i.e. using a computer without in person instruction) 3 

### □ Some in - person and some online 4 

### □ Some in - person and some at a work/ business location

**3.**

_________________________

Name of Program

_________________________ Name of Institution

_________________________

City/State We are interested in the name of the program, not a list of the courses you took within the program. | | | If 99 Other, (Specify)

_____________________ 1 

### □ Vocational/technical certificate (< 2 years) 2 

### □ Associate’s degree ( AS, 2 years , vocational ) 3 

### □ Associate’s degree ( A A , 2 years , academic ) 4 

### □ Bachelor’s degree or equivalent (BA/BS, 4 years) 5 

### □ Master’s degree or equivalent (MA/MS) 6 

### □ Doctoral degree (MD, PhD) 7 

### □ Other professional degree/certificate 99 

### □ Other (Specify) START | | | / | | | | | MONTH YEAR END | | | / | | | | | MONTH YEAR 1 

### □ All in - person 2 

### □ All online (i.e. using a computer without in person instruction) 3 

### □ Some in - person and some online 4 

### □ Some in - person and some at a work/ business location

**4.**

_________________________

Name of Program

_________________________ Name of Institution

_________________________

City/State We are interested in the name of the program, not a list of the courses you took within the program. | | | If 99 Other, (Specify)

_____________________ 1 

### □ Vocational/technical certificate (< 2 years) 2 

### □ Associate’s degree ( AS, 2 years , vocational ) 3 

### □ Associate’s degree ( A A , 2 years , academic ) 4 

### □ Bachelor’s degree or equivalent (BA/BS, 4 years) 5 

### □ Master’s degree or equivalent (MA/MS) 6 

### □ Doctoral degree (MD, PhD) 7 

### □ Other professional degree/certificate 99 

### □ Other (Specify) START | | | / | | | | | MONTH YEAR END | | | / | | | | | MONTH YEAR 1 

### □ All in - person 2 

### □ All online (i.e. using a computer without in person instruction) 3 

### □ Some in - person and some online 4 

### □ Some in - person and some at a work/ business location

**FIELD OF STUDY CODES** 1 = Agriculture, natural resources, and related sciences 2 = Architecture, planning, and related services 3 = Area, ethnic, cultural, and gender studies 4 = Arts
— visual and performing 5 = Biological and biomedical sciences 6 = Business, management, marketing, and related support services 7 = Communication, journalism, communication technologies, and related programs 8 = Computer and information sciences and support services 9 = Construction trades 10 = Cosmetology, funeral services, and culinary service 11 = Education 12 = Engineering, en gineering technologies/technicians 13 = English language and literature/letters 14 = Family and consumer sciences/human sciences 15 = Foreign languages, literatures, and linguistics 16 = Health professions and related clinical sciences 17 = Legal professio ns and studies 18 = Liberal arts and sciences, general studies and humanities 19 = Library science 20 = Mathematics and statistics 21 = Mechanical and repair technologies/technicians 22 = Multi/interdisciplinary studies 23 = Parks, recreation, leisure and fitness studies 24 = Precision production 25 = Philosophy, religion & theology 26 = Physical sciences 27 = Psychology 28 = Public administration and social service professions 29 = Science technologies/technicians 30 = Security & protective services 31 = Social sciences and history (except psychology) 32 = Transportation & materials moving 99 = Other 

### A **. PROGRA M**  **SELECTION (CON’T)**3

**F. What was/is your reason for applying/enrolling?** 

Select all that apply **G. Did you**  **complete the program?**  **H. What were the reasons you stopped**  **attending?** Select all that apply **1.** 1 

### □ To gain new job or occupational skills 2 

### □ To help move up in the job I already have 3 

### □ To help me get a new job I’m interested in 4 

### □ To prepare for occupational certification or work - related licensure 5 

### □ To earn course credits needed for a program at a different school 6 

### □ To take cour ses for recreation, self - improvement or personal interest 7 

### □ To compl ete an undergraduate degree 99 

### □ Other (Specify)

________________________________ ___________________ 0 

### □ Stopped Attending 1 

### □ Yes **GO TO NEXT P**  **ROGRAM OR B1**  2 

### □ Still Enrolled **GO TO NEXT P**  **ROGRAM OR B1**  1 

### □ Offered or got a good job 2 

### □ Did not have money for tuition/cost of program 3 

### □ Needed to work more so didn’t have enough time 4 

### □ Did not expect to get a good job after completion 5 

### □ Not satisfied with the quality of the program 6 

### □ Program was too hard/did not have the right background to learn the new skills 7 

### □ Physical, mental health, family, or personal reasons 8 

### □ Was called to active duty/joined the armed forces 99 

### □ Other (Specify)

________________________________ _______ **2.** 1 

### □ To gain new job or occupational skills 2 

### □ To help move up in the job I already have 3 

### □ To help me get a new job I’m interested in 4 

### □ To prepare for occupational certification or work - related licensure 5 

### □ To earn course credits needed for a program at a different school 6 

### □ To take cour ses for recreation, self - improvement or personal interest 7 

### □ To compl ete an underg raduate degree 99 

### □ Other (Specify)

________________________________ ___________________ 0 

### □ Stopped Attending 1 

### □ Yes **GO TO NEXT P**  **ROGRAM OR B1**  2 

### □ Still Enrolled **GO TO NEXT P**  **ROGRAM OR B1**  1 

### □ Offered or got a good job 2 

### □ Did not have money for tuition/cost of program 3 

### □ Needed to work more so didn’t have enough time 4 

### □ Did not expect to get a good job after completion 5 

### □ Not satisfied with the quality of the program 6 

### □ Program was too hard/did not have the right background to learn the new skills 7 

### □ Physical, mental health, family, or personal reasons 8 

### □ Was called to active duty/joined the armed forces 99 

### □ Other (Specify)

________________________________ _______ **3.** 1 

### □ To gain new job or occupational skills 2 

### □ To help move up in the job I already have 3 

### □ To help me get a new job I’m interested in 4 

### □ To prepare for occupational certification or work - related licensure 5 

### □ To earn course credits needed for a program at a different school 6 

### □ To take cour ses for recreation, self - improvement or personal interest 7 

### □ To compl ete an undergraduate degree 99 

### □ Other (Specify)

________________________________ ___________________ 0 

### □ Stopped Attending 1 

### □ Yes **GO TO NEXT P**  **ROGRAM OR B1**  2 

### □ Still Enrolled **GO TO NEXT P**  **ROGRAM OR B1**  1 

### □ Offered or got a good job 2 

### □ Did not have money for tuition/cost of program 3 

### □ Needed to work more so didn’t have enough time 4 

### □ Did not expect to get a good job after completion 5 

### □ Not satisfied with the quality of the program 6 

### □ Program was too hard/did not have the right background to learn the new skills 7 

### □ Physical, mental health, family, or personal reasons 8 

### □ Was called to active duty/joined the armed forces 99 

### □ Other (Specify)

________________________________ _______ **4.** 1 

### □ To gain new job or occupational skills 2 

### □ To help move up in the job I already have 3 

### □ To help me get a new job I’m interested in 4 

### □ To prepare for occupational certification or work - related licensure 5 

### □ To earn course credits needed for a program at a different school 6 

### □ To take cour ses for recreation, self - improvement or personal interest 7 

### □ To compl ete an undergraduate degree 99 

### □ Other (Specify)

________________________________ ___________________ 0 

### □ Stopped Attending 1 

### □ Yes **GO TO NEXT P**  **ROGRAM OR B1**  2 

### □ Still Enrolled **GO TO NEXT P**  **ROGRAM OR B1**  1 

### □ Offered or got a good job 2 

### □ Did not have money for tuition/cost of program 3 

### □ Needed to work more so didn’t have enough time 4 

### □ Did not expect to get a good job after completion 5 

### □ Not satisfied with the quality of the program 6 

### □ Program was too hard/did not have the right background to learn the new skil ls 7 

### □ Physical, mental health, family, or personal reasons 8 

### □ Was called to active duty/joined the armed forces 99 

### □ Other (Specify)

________________________________ _______ 

### A **. PROGRA M**  **SELECTION (CON’T)**4 

### B1. **There are many factors students may consider when choosing an educational or training program. For your**  **most recent program , how important was each of the factors listed below in your decision to enroll**  **in this program? Were these factors very important, s omewhat important, or not important in your**  **decision to choose the program?** Select one per row VERY IMPORTANT SOMEW HAT

IMPORTANT NOT

IMPORTANT a. Quality of faculty/teachers 1 

# □ 2 

# □ 3 

# □ b. Ability to reach or talk to faculty/teachers 1 

# □ 2 

# □ 3 

# □ c. Opportunities for hands - on learning 1 

# □ 2 

# □ 3 

# □ d. Skills taught seemed very related to desired job, promotion, or industry certification 1 

# □ 2 

# □ 3 

# □
e. Availability/quality of career counseling/case management 1 

# □ 2 

# □ 3 

# □ f. Availability/quality of work readiness training (e.g. resume writing, job interviewing, career information) 1 

# □ 2 

# □ 3 

# □ g. Job placement assistance 1 

# □ 2 

# □ 3 

# □ h. Academic advising/support 1 

# □ 2 

# □ 3 

# □ i. Availability of financial aid, such as loans, scholarships, or grants 1 

# □ 2 

# □ 3 

# □ j. C onvenience of location 1 

# □ 2 

# □ 3 

# □ k. Convenience of time when classes are offered 1 

# □ 2 

# □ 3 

# □ l. Duration of program 1 

# □ 2 

# □ 3 

# □ m. Availability of an internship as part of the program 1 

# □ 2 

# □ 3 

# □ n. Recommended by a friend, relative, or advisor 1 

# □ 2 

# □ 3 

# □

**B. EXPERIENCE WITH THE MOS**  **T RECENT OR MOST RECENTLY COMPLETED PROGRA**  **M**5 

### B2. **Considering these same factors, please rate your satisfaction with the**  **most recent education or training program**  **you attended. Would you say you are/were very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied?**  Select one per row VERY SATISFIED SOMEW HAT

SATISFIED SOMEW HAT

DISSATISFIED VERY

DISSATISFIED a. Quality of faculty/teachers 1 

# □ 2 

# □ 3 

# □ 4 

# □ b. Ability to reach/talk to faculty/teachers 1 

# □ 2 

# □ 3 

# □ 4 

# □ c. Opportunities for hands - on - learning 1 

# □ 2 

# □ 3 

# □ 4 

# □ d. Appropriateness of skills taught to desired job, promotion, or industry certification 1 

# □ 2 

# □ 3 

# □ 4 

# □ e. Availability and/or quality of career counseling/case management 1 

# □ 2 

# □ 3 

# □ 4 

# □ f. Wo rk readiness (e.g. resume writing, job interviewing) and career information 1 

# □ 2 

# □ 3 

# □ 4 

# □ g. Job search/placement assistance 1 

# □ 2 

# □ 3 

# □ 4 

# □ h. Academic advising/support 1 

# □ 2 

# □ 3 

# □ 4 

# □ i. Availability of financial aid, such as loans, scholarships, or grants 1 

# □ 2 

# □ 3 

# □ 4 

# □ o. g eographic location/convenience 1 

# □ 2 

# □ 3 

# □ 4 

# □ **B3. Overall, how would you rate your most recent education/training program?** 

0 

# □ Excellent 1 

# □ Good 2 

# □ Fair 3 

# □ Poor **B4. Have you received career counseling, work readiness, or job search assistance from any other person**  **or organization outside your most recent educational or training program since [fill APPLICATION MONTH,**  **YEAR]** 

### ? Select all that apply Wo rk readiness (e.g. resume writing, job interviewing) and career information Job search/placement assistance Career counseling/case management

a. College Career Center 1 

# □ 2 

# □ 3 

# □ b. Government Agency 1 

# □ 2 

# □ 3 

# □ c. Local/community workforce development center or organization (e.g. one - stop career center) 1 

# □ 2 

# □ 3 

# □ d. Community based or neighborhood organization 1 

# □ 2 

# □ 3 

# □ e. High sch ool advisor 1 

# □ 2 

# □ 3 

# □

**B. EXPERIENCE WITH THE MOS**  **T RECENT OR MOST RECENTLY COMPLETED PROGRA**  **M (CON’T)** 6 

### B4. **Have you obtained a professional certification or a state or industry license? A professional**  **certification or license shows you are qualified to perform a specific job and includes things like Certified**  **Me dical A**  **ssistant, commercial truck driving, automot**  **ive technician, or an IT certification (e.g., Cisco,**  **networking, security technology, etc. )**  **.**

1 

# □ Yes 0 

# □ No **GO TO C1, PA GE 7** 


### B **5 .**  **What is the name of any certification(s) or license(s) and what type of credential is it?** Select one per row **A. Name of**  **credential B. Industry Certification**  **C. State License D. Other**  1. 1 

# □ 2 

# □ **3** 

# □ 2. 1 

# □ 2 

# □ **3** 

# □ 3. 1 

# □ 2 

# □ **3** 

# □ **B. EXPERIENCE WITH THE MOST RECENT PROGRA M (CON’T)** 7 

### The next few questions are designed to help us understand how students pay for expenses to attend **educational and vocational training programs. C**  **1. Please think about**  **all of the educational and training**  **programs you may have attended since [fill**  **APPLICA**

**TI ON MONTH/YEA**  **R]. W hat was the**  **total cost of your tuition**  **to attend the program(s)?** Please i nclude room an d board if you had this expense. Please i nclude any costs covered by financial aid, grants, loans or scholarships. $ | | | | , | | | |

. | 0 | 0 | **C2 .**  **Now we would like to know the different funding sources you used to cover your costs in attending all**  **the se**  **educational and training programs**  **and how the availability of the funding source affected your choice to enroll.**  Select one per row
**Funding Source Did y**  **ou receive funds?**  **If y es, how much of y**  **our overall spending did it cover?**  **If y ou had not received**  **funding from this source, would y**  **ou have enrolled in these programs?**  GRANTS (Financial aid that does not need to be paid back) a. Federal Pell Grants 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know b. Other federal/state/school grants 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know
c. Job training vouchers or I ndividual Training Account s from local One - Stop Center or workforce development agency 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know d. Grants or tuition reimbursement f rom your employer 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know LOANS (Financial aid that needs to be paid back) e. Federal/state/school loans 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know f. Loans from private banks 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1⁄2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know SCHOLARSHIPS (Financial aid awarded based on merit or status

— e.g. because you are citizen of state, member of church, etc.) g. Scholarships 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 

### C. PA **YING FOR EDUCA**

**TI ON A**  **ND TRA INING PROGRA**  **MS**8 

### Select one per row **Funding Source Did y**  **ou receive funds?**  **If ye**  **s, how much of y our overall** 

**spending did it cover? If y**  **ou had not received funding from this source,**  **would y ou have enrolled in**  **this program?** OTHER h. From Veteran’s Benefits (including GI Bill) 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know i. Gifts from family and friends 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know j. My savings 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know k. Credit Cards 1 

## □ Yes 0 

## □ No d 

## □ I don’t know 1 

### □ Less than 1/4 2 

### □ More than 1/4 but less than 1/2 3 

### □ About 1/2 4 

### □ More than 1/2 1 

## □ Yes 0 

## □ No d 

## □ I don’t know



### C3. **Overall, about what portion of the total cost of the programs would you say you will pay through student**  **loans offered to you from schools, banks, or other organizations?** Please do not include money that you borrowed from friends or family. 1 

### □ None 2 

### □ Less than 1/4 3 

### □ More than 1/4 but less than 1/2 4 

### □ About 1/2 5 

### □ More than 1/2



### C4 **. Right now, how much do you still owe in student loans**  **or credit card payments used to cover tuition ?** 

$ | | | | , | | | |

. | 0 | 0 |

**GO TO C5** 

### C **. PA**  **YING FOR AL**  **L EDUCA TIONA**  **L A ND TRA**  **INING PROGRA**  **M S**  **(CON’T)**9 

### C5 **. We are also interested in learning about**  **financial assistance you may have received to help you with**  **other expenses (not including tuition and fees) to attend any educational or training programs?**  **Since [fill A PPLICA** 

**TION MONTH, YEA R], have you received**  **assistance in the form of cash, vouchers, gift cards, or reimbursement to help you pay for any of the following:**  ( Please do not include financial assistance you may have received from friends or family. ) Select one per row YES NO 

### a. Books? 1 

# □ 0 

# □ b. Tools or other supplies? 1 

# □ 0 

# □ c. Clothes or other uniforms? 1 

# □ 0 

# □ d. Transportation such as gas cards or bus passes? 1 

# □ 0 

# □ e. Child care? 1 

# □ 0 

# □ **GO TO E1, PA GE 11**  **C .**  **PA YING FOR**  **AL L EDUCA**  **TIONA L A**  **ND TRA INING**  **PROGRA M**  **S (CON’T)** 10 

### ONLY COMPLETE **SECTION D IF YOU DID NOT A**  **TTE ND A**  **NY EDUCA**

**TI ONA**  **L PROGRA M**  **SINCE [fill PROGRA**  **M A T INSTITUTION]** 

**D1 .**  **How important was each of the following factors in your decision to not attend any educational or**  **training program since [fill PROGRA**  **M A T INSTITU**  **TION]?** Select one per row **MA JOR**  **FACTOR MINOR** 

**FACTOR NOT A** 

**FACTOR** a. O ffered or got a good job 1 

# □ 2 

# □ 3 

# □ b. Did not have money for tuition/cost of program 1 

# □ 2 

# □ 3 

# □
c. Needed to work more so didn’t have enough time for program 1 

# □ 2 

# □ 3 

# □ d. Did not expect to get a good job after completing the programs I knew about 1 

# □ 2 

# □ 3 

# □
e. W as not satisfied with the quality of the program 1 

# □ 2 

# □ 3 

# □ f. W as undecided about which course of study to pursue 1 

# □ 2 

# □ 3 

# □ g. Did not think I had the right background to learn the new occupational/ vocational skills 1 

# □ 2 

# □ 3 

# □ h. Family reasons (e.g. needed to take care of family member, had child) 1 

# □ 2 

# □ 3 

# □ i. Had physical or mental health challenges 1 

# □ 2 

# □ 3 

# □ j. Other personal reasons (e.g. other interests besides school ) 1 

# □ 2 

# □ 3 

# □ k. I was called to active duty and/or I joined one of the armed forces/military 1 

# □ 2 

# □ 3 

# □

**D. REA SONS FOR NOT ATTENDING EDUCA**  **TIONAL OR TRA INING PROGRAM(S)** 11 

### E1. **Which of these conditions describes your main activity during the week?**  Select one only 1 

# □ Wo rk ing 2 

# □ Seeking employ me nt 3 

# □ Caring for children or other relatives at home without pay
4 

# □ Volunteering at least 20 hours per week 5 

# □ Part - tim e student 6 

# □ Full - time student
7 

# □ Medical or maternity leave 8 

# □ Som ething else (Specify )

______________________________ **E2. How many hours do you work in a typical week**  **?** Enter “0” if not currently employed | | | | **E2a. Using the list of occupations, please select the code that**  **best describes your current job or most recent**  **job if you’re not currently employed. If you are currently holding more than one job, select the occupation where you work the most hours.**  Select one only | | | LIST OF OCCUPATIONS To make sure you hav e found the best code, please review all occupations before making your choice. 1 Management 12 Protective Service 2 Business and Financial 13 Food Preparation and Serving Related 3 Computer and Mathematical 14 Building and Grounds Cleaning and Maintenance 4 Architecture and Engineering 15 Personal Care and Service 5 Life, Physical, and Social Science 16 Sales and Related 6 Community and Social Services 17 Office and Administrative Support 7 Legal 18 Farming, Fishing, and Forestry 8 Education, Training, and Library 19 Construction and Extracting 9 Arts, Design, Entertainment, Sports, and Media 20 Installation, Maintenance, and Repair 10 Healthcare Practitioners and Technical 21 Production 11 Healthcare Support 22 Transportation and Material Moving 

### E2b. **In what month and year did you begin working at this job (current or most recent) for pay?** | | | / | | | | | MONTH YEAR 

### E. EM **PLOYMENT ST AT**  **US**12 

### E3. **How much do you currently earn per hour at this job or did or did you earn in your most recent job?**  **Your best estimate is fine.** Select one only 1 

# □ $7.25 or less
2 

# □ $7.26
- $10.00
3 

# □ $10.01
- $13.00
4 

# □ $13.01
- $16.00
5 

# □ $16.01
- $19.00
6 

# □ $19.01
- $23.00
7 

# □ $23.01
- $25.00
8 

# □ $25.01 or more

**E4. Thinking about your current job, please rate your satisfaction with the job’s benefits such as . . .**  Select one per row VERY SATISFIED SOMEW HAT

SATISFIED SOMEW HAT

DISSATISFIED VERY

DISSATISFIED 

### a. Salary 1 

# □ 2 

# □ 3 

# □ 4 

# □ b. Healthcare benefits 1 

# □ 2 

# □ 3 

# □ 4 

# □ c. Pension/retirement benefits 1 

# □ 2 

# □ 3 

# □ 4 

# □ d. 401K/IRA 1 

# □ 2 

# □ 3 

# □ 4 

# □ e. Job Security 1 

# □ 2 

# □ 3 

# □ 4 

# □ f

. Opportunities for additional or specialized training 1 

# □ 2 

# □ 3 

# □ 4 

# □ g. Opportunities for advancement/promotion 1 

# □ 2 

# □ 3 

# □ 4 

# □ h. Intellectual challenge 1 

# □ 2 

# □ 3 

# □ 4 

# □ i. Level of responsibility 1 

# □ 2 

# □ 3 

# □ 4 

# □ j. Contribution to society 1 

# □ 2 

# □ 3 

# □ 4 

# □ k. Ability to use skills you learned from education and training 1 

# □ 2 

# □ 3 

# □ 4 

# □ **E. EM PLOYMENT ST**  **AT US (CON’T)** 

**IF CURREN TLY UNEMPLOYED GO TO F1, PA**  **GE 13 , OTHERWISE CONTINUE.** 13 

### E5. **Who was most**  **helpful to you in getting your current job?** Select one only 1 

# □ No one, I got the position on m y own 2 

# □ Counselors, teacher, or other staff at the most recent education or training program I attended 3 

# □ College/school career center
4 

# □ A government agenc y 5 

# □ Local/community workforce development center or organization (e.g. One - Stop Career Center) 6 

# □ Co mmunity base or neighborhood organization
7 

# □ High school advisor 8 

# □ Family/relatives (e.g. parents, guardians) 9 

# □ Previous employer 10 

# □ Friends **E6. To what extent is the work you do on your current job related to any education or training you may hav**  **e received since [fill A**  **PPLICA TION MONTH/YEA**  **R]?** Select one only 1 

# □ Closely related to a training program I attended/am attending 2 

# □ Som ewhat related to a training program I attended/am attending 3 

# □ I did not attend a training program, so work not at all related 4 

# □ I did attend a training program, but work not at all related **E7. Did any of these factors influence your decision to work in an area outside the program field you**  **applied for in [fill A PPLICA**  **TION MONTH/YEA R] which w**  **as [fill PROGRAM AT INSTITUTION**  **]** 

### ? Select one per row YES NO 

### a. Pa y, prom otion opportunities 1 

# □ 0 

# □ b. Wo rk ing conditions (e.g. hours, equipment, working environment) 1 

# □ 0 

# □ c. Job location 1 

# □ 0 

# □ d. Change in career or interests 1 

# □ 0 

# □ e. Family - related reasons (e.g. children, spouse’s job moved) 1 

# □ 0 

# □ f. Job in program field not available 1 

# □ 0 

# □ g. Som e other reason (Specify) 1 

# □ 0 

# □

________________________________ ________________________ **E. EM PLOYMENT ST**  **AT US (CON’T)** 

**GO TO F1, PAGE 13**14 

### F1. **Do you plan on enrolling in any other educational or vocational training programs in the future?** 

1 

# □ Yes 0 

# □ No **GO TO G**  **1 , PAGE 15**  

### F **2. What type of degrees or certification programs and in what fields of study do you plan on pursuing?**  Please use the codes below to complete table. SELECT ONE CODE PER ROW


### a. Vocational/technical certificate (less than 2 years) 

## | | | b. Associate’s degree (AS , 2 years , vocational ) 

## | | |
c. Associate’s degree (AA, 2 years , academic ) d

. Bachelor’s degree or equivalent (BA/BS, 4 years) 

## | | |
e . Master’s degree or equivalent (MA/MS) 

## | | | f

. Doctorate/Ph.D. (MD, PhD) 

## | | | g . Other professional degree/certificate (Specify) 

## | | |

________________________________ ________________________ h

. Som e other (Specify) 

## | | |

________________________________ ________________________
**FIELD OF STUDY CODES** 1 = Agriculture, natural resources, and related sciences 2 = Architecture, planning, and related services 3 = Area, ethnic, cultural, and gender studies 4 = Arts
— visual and performing 5 = Biological and biomedical sciences 6 = Business, managem ent, marketing, and related support services 7 = Communication, journalism, communication technologies, and related programs 8 = Computer and information sciences and support services 9 = Construction trades 10 = Cosmetology, funeral services, and cu linary service 11 = Education 12 = Engineering, engineering technologies/technicians 13 = English language and literature/letters 14 = Family and consumer sciences/human sciences 15 = Foreign languages, literatures, and linguistics 16 = Health professions and related clinical sciences 17 = Legal professions and studies 18 = Liberal arts and sciences, general studies and humanities 19 = Library science 20 = Mathematics and statistics 21 = Mechanical and repair technologies/technicians 22 = Multi/interdisciplinary studies 23 = Parks, recreation, leisure and fitness studies 24 = Precision production 25 = Philosophy, religion & theology 26 = Physical sciences 27 = Psy chology 28 = Public administration and social service professions 29 = Scienc e technologies/technicians 30 = Security & protective services 31 = Social sciences and history (except psychology) 32 = Transportation & materials moving 99 = Other 

### F. FUTURE GOA **LS**

### 15 **These last questions ask for some general**  **demographic information. G1**  **. In what year were you born?**  | | | | | YEAR 

### G2. **Are you Hispanic or Latino?**

1 

# □ Yes 0 

# □ No **G3 .**  **What is your race?** Select all that apply 1 

# □ Wh ite 2 

# □ Black or African American 3 

# □ Asian
4 

# □ Native Hawaiian or Other Pacific Islander
5 

# □ Am erican Indian or Alaska Native **G4 .**  **Are you...**

1 

# □ Male 2 

# □ Female **G5. Do you have any children under 18?**  **Include birth, adopted, foster, or stepchildren.**  1 

# □ Yes 2 

# □ No **G6. What is your marital status as of tod**  **ay?** Select one only 1 

# □ I am single 2 

# □ I am married/remarried 3 

# □ I am separated
4 

# □ I am divorced or widowed **G7. We will be mailing you a check in a couple of**  **weeks and we would like to confirm the spelling of your name and address where we should sen**  **d the payment.** 

________________________________ _________ FIRST NAME

________________________________ _________ MIDDLE INITIAL/NAME

________________________________ _________ LAST NAME

________________________________ _________ STREET 1

________________________________ _________ STREET 2

________________________________ _________ APT. #

________________________________ _________ CITY

________________________________ _________ STATE

________________________________ _________ ZIP
**G8. Thank you for participating in the survey and**  **providing your address. Please provide your telephone number**  **and email address because**  **we may need to contact you again in the future.**  | | | | - | | | | - | | | | | AREA CODE



### ________________________________ _________ EM AIL 

### G. BA **CKGROUND A ND CONT**  **AC T INFORM**  **AT ION** 

### 16