CTE Student Information Survey (SP 2020)

Dear Student:

Your help is needed with the following questionnaire. the information you provide will make sure that the college continues to receive funding from the state for career/technical education programs. Your cooperation in completing this survey is vital. YOUR RESPONSES WILL BE TREATED WITH COMPLETE CONFIDENTIALITY. Thank you for your cooperation.

Sincerely,

Vice President of Instruction

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* 1. Student ID Number

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* 2. What college are you attending?

Contra Costa College

Diablo Valley College

Los Medanos College

Personal Information

Please indicate your status with respect to the following statements

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* 3. I am a single pregnant female and/or single parent with custody of a minor child or children.

Yes

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* 4. Displaced Homemaker (Check "yes" if you have worked without pay at home, taking care of your family.)

Yes

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* 5. Migrant Worker (Check "yes" if you have moved in the last 36 months so that you and/or a family member could work in agriculture, dairy or in fishing.)

Yes

Financial Status

Please indicate your family size and income.
(NOTE: If your parent(s) claim you as a dependent for income tax purposes, use their household size and income.)

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* 6. Family Size:

Yourself Only

11+

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 7. Your annual household income is:

Less than: $18,210

Less than: $24,690

Less than: $31,170

Less than: $37,650

Less than: $44,130

Less than: $50,610

Less than: $57,090

Less than: $63,570

More than: $63,570

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* 8. Financial Assistance - I am currently receiving benefits from:

TANF/CalWORKS

SSI(Supplemental Security Income)

GA(General Assistance)

BOGG or BOGW(Board of Governors Grant or Waiver)

Section 8 Housing Assistance

Pell Grant Award

EOPS

None

Other (please specify)