Health Career Explorers Alumni
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1. Default Section
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1
. Please fill out the information below. Please include a PERMANENT address where you will be able to receive mail in the future.
Thank you.
Please fill out the information below. Please include a PERMANENT address where you will be able to receive mail in the future. Thank you.
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
Country:
Email Address:
Phone Number:
2
. What year did you, or will you, graduate from High School?
What year did you, or will you, graduate from High School?
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
3
. Are you currently enrolled in college or will you be enrolling after high school graduation?
(If you have not graduated high school please skip the next 3 questions)
Are you currently enrolled in college or will you be enrolling after high school graduation? (If you have not graduated high school please skip the next 3 questions)
Currently Enrolled
Will Enroll after H.S. Graduation
4
. If you are currently enrolled in college which college are you attending? If you have graduated college, please list where you attended.
If you are currently enrolled in college which college are you attending? If you have graduated college, please list where you attended.
5
. If you are currently enrolled in college, what major are you studying (health related or not)? If you have graduated college, what was your major?
If you are currently enrolled in college, what major are you studying (health related or not)? If you have graduated college, what was your major?
6
. If you are currently enrolled in college, please indicate which career you are pursuing and what you plan to do after receiving your degree. If you have graduated college, what career have you pursued?
If you are currently enrolled in college, please indicate which career you are pursuing and what you plan to do after receiving your degree. If you have graduated college, what career have you pursued?
7
. What is the highest level of education that you plan to pursue?
What is the highest level of education that you plan to pursue?
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Other Certifications
8
. Do you feel that the Health Career Explorers program provided you with enough information to make an educated decision on which career to pursue?
Do you feel that the Health Career Explorers program provided you with enough information to make an educated decision on which career to pursue?
Definitely Yes
Somewhat Yes
In the Middle
Somewhat No
Definitely No
9
. Would you consider returning to Northern Kentucky to work in a local hospital or other healthcare setting after recieving your degree and certification? If you are NOT pursuing a health career, please skip this question.
Would you consider returning to Northern Kentucky to work in a local hospital or other healthcare setting after recieving your degree and certification? If you are NOT pursuing a health career, please skip this question.
Definitely Yes
Somewhat Yes
In the Middle
Somewhat No
Definitely No
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