Erie Niagara Area Health Education Center (AHEC) Program Participant Survey

Dear Erie Niagara AHEC member,

In the past, you participated in a program sponsored by the Erie Niagara AHEC. We are trying to determine if our programs are helpful to students who are considering health care careers. We would appreciate it if you could complete this brief survey and return it to us and also receive a free gift post survey completion.

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* 1. Please enter your Participant ID (located in your email or cover letter)

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* 2. When did you participate in the Erie Niagara AHEC program?

Grade K-8 (School Year/Summer)

High School (School Year/Summer)

College (Job Shadow/Internship)

Do Not Recall

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* 3. Did you attend College, Trade School or Certificate Program?

Yes

Attended, but did not complete

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* 4. Please tell us about your program.

College Name

City

State

Degree Earned

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* 5. If not enrolled in college, do you wish to pursue a career in a healthcare/STEM field?

Yes

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* 6. If yes, what is your intended major of choice in the healthcare/STEM field?

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* 7. If you are currently employed in a healthcare/STEM carer field, what is your current profession?

Profession

State

Zip code

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* 8. Did your experience with Erie Niagara AHEC help you choose a healthcare/STEM career?

Yes

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* 9. If yes, please explain how Erie Niagara AHEC helped you in doing so

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* 10. Please complete the following If you are interested in gaining free membership at the Erie Niagara AHEC. Membership includes free subscription to the Community Connection newsletters, events, program notices, career opportunities in healthcare/STEM fields etc.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address