Development and Evaluation of a Pedagogical Model for an Open University in Nepal

The purpose of this survey is to assist the Open University of Nepal in the collection of demographic data and the opportunity for research study. Participation in this survey is voluntary. Please answer the questions below. Some require typed answers while others only require 'a click' on the choice of preference.
Questions with a * must be answered.

* 1. What is your first name?

* 2. What is your last name?

* 3. Do you own a mobile phone?

* 5. If you own a mobile phone, what is your phone number?

* 6. What is your email address?

* 7. What is your gender?

* 8. Which category below includes your age?

* 9. Which of the following categories best describes your marital status?

* 10. How many children do you have?

* 11. I am:

* 12. If you are employed, what is your job?

* 13. If you are employed, do you work:

* 14. I have access to a computer:

* 15. My Internet skills are:

* 16. What is your first language?

* 17. What is your ethnic background?

* 18. What is your reading level in your first language?

* 19. What is your writing level in your first language?

* 20. What is your level in Nepalese?

* 21. What is your level in English?

* 22. What additional languages do you speak?

* 23. What is your level in each additional language?

* 24. In what region did you grow up?

* 25. What is the name of your hometown?

* 26. Would you be interested in further education if an Open University offered online courses that you could afford?

* 27. If so, what subject area would interest you?

* 28. Would you be interested in participating as a student in a free, 2-week online course called “Introduction to Online Learning”? It will improve your online skills and also help to improve online learning for people in your region? Required time: 1-2 hours per day.

* 29. Would you be willing to be interviewed in person or over the telephone by a researcher at the end of the course?

The purpose of the research project is to identify individuals in your region who may be interested in online learning.
Your participation in the research study is voluntary. You may choose not to participate. If you decide to participate in the research study, you may withdraw at any time. If you decide not to participate in the study or if you withdraw from participating at any time, you will not be penalized.
We will do our best to keep your information confidential. All data is stored in a password protected electronic format. The results of the research study will be used for scholarly purposes only.
If you have any questions about the research study, please contact:
The research has been reviewed according to Athabasca University Research Ethics Board procedures for research involving human subjects.
ELECTRONIC CONSENT: Please select your choice below.

Clicking on the "Done" button below indicates that:

• you have read the above information
• you voluntarily agree to participate
• you are at least 18 years of age

If you do not wish to participate in the research study, please decline participation by not submitting this survey. If you choose 'Done' the data will be included for analysis in the research study, and you ‘may’ be chosen to be contacted by the researcher for further participation in other parts of the research.