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Senior Exit Survey
1. Default Section
1
. What is your student ID #?
What is your student ID #?
*
2
. Please enter the information below:
Please enter the information below:
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:
Email Address:
Phone Number:
*
3
. Please indicate your sex.
Please indicate your sex.
Male
Female
4
. Please indicate your racial background.
Please indicate your racial background.
American Indian
Asian
Hispanic
Black
White
Other
5
. What is your homeroom?
What is your homeroom?
*
6
. Who is your counselor?
Who is your counselor?
Carole DeLuca
Joe Andrews
Kelly Barney
Mairead Collins-Tooher
Esperanza Diaz
Ashley Forshaw
Darlene Goodwin
Dinie James/Danielle Paccione
Fran Levin-Vadeboncoeur
Melissa Meir
Spiro Milas
Orquidea Sanso
Michelle Supple
7
. Please indicate which college entrance tests you took with your best scores in each:
Please indicate which college entrance tests you took with your best scores in each:
SAT 1 - Critical Reading
Best Score
8
. Please indicate which college entrance tests you took with your best scores in each:
Please indicate which college entrance tests you took with your best scores in each:
SAT 1 -Math
Best Score
9
. Please indicate which college entrance tests you took with your best scores in each:
Please indicate which college entrance tests you took with your best scores in each:
SAT 1 - Writing
Best Score
10
. Please indicate which college entrance tests you took with your best scores in each:
Please indicate which college entrance tests you took with your best scores in each:
ACT
Best Composite Score
*
11
. What are your plans after graduation?
What are your plans after graduation?
School/College
Military Service - Skip to Section #5
Permanent Job - Skip to Section #6
Don't Know - Skip to Section #7
11%
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