University of Maryland Eastern Shore

* 1. Student Name:

* 2. UMES Student ID:

* 3. Contact Number:

* 4. Email:

* 5. Gender:

* 6. Race/Ethnicity:

* 7. Enrollment Status:

* 8. Student Status:

* 9. Classification:

* 10. Major:

* 11. Please rate the following categories

  4= Excellent  3= Good 2= Average 1= Poor
Residence Life
Service from staff
Dining Services
Overall Customer Service 
Overall Experience
Campus Life
Academic Advising

* 12. Were you involved in any campus life activities?

* 13. Personal reasons you are leaving the institution:

  Family matters Health (Illness) Mental Health
Personal Reasons

* 14. Financial reasons you are leaving the institution:

  Not enough financial aid Personal debt management  Need to work full-time Could not afford to buy books needed for classes
Financial Reasons

* 15. Academic reasons you are leaving the institution:

  Academic rigor (classes were too difficult) Not prepared for college at this time Decided not to pursue a Bachelor's Major not offered Decided to pursue education elsewhere Did not have access to books
Academic Reasons

* 16. Institutional Climate/Environmental Factors for leaving the institution:

  Poor treatment by office staff on campus Poor treatment by faculty  Professors were inaccessible/non-responsive  Felt shuffled around campus without concerns being met Overall lack of support on campus 
Institutional Climate/ Enviromental Factors
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