Question Title

* 1. First Name

Question Title

* 2. Middle Name

Question Title

* 3. Last Name

Question Title

* 4. Student ID:

Question Title

* 5. School

Question Title

* 6. Gender

Question Title

* 7. Date of Birth

Date

Question Title

* 8. Programs Participated In (choose all that apply)

Question Title

* 9. Choose one of the options based on how much you agree with the statement on the left. For example, if you strongly disagree with the sentence, choose the left hand circle. If you  strongly agree with the sentence, choose the far right circle.

  Strongly Disagree Disagree Don't know Agree Strongly Agree
It's important to me to earn more than a high school diploma.
I need more than a high school diploma to get the kind of job I want.
It's OK to miss school because I don't feel like going.
Even if school work is hard I can learn it.
If I went to college, I would fit in there.
I know what kind of student groups there are at college.
Getting a college degree is a good thing for me to do.
I know what type of employment I want as an adult.
I want to attend college.
I think the cost of attending college will stop me from going.
I can achieve my educational goals.

Question Title

* 10. Has anyone in your family graduated from a 2 year or 4 year college? (Choose all that apply)

Question Title

* 11. Has anyone in your family graduated from a 2 year or 4 year college? (Choose all that apply)

Question Title

* 12. Has anyone in your family graduated from a 2 year or 4 year college? (Choose all that apply)

Question Title

* 13. What is the highest level of education that you  HOPE to obtain?

Question Title

* 14. What is the highest level of education that you  EXPECT to obtain?

Question Title

* 15. What activities have you participated in where you have learned about careers? (Choose all that apply)

Question Title

* 16. What career or profession would you like to have when you finish school?

Question Title

* 17. Answer the questions below by checking one of the answers in the right three columns.

  Yes No Not Sure
I visited Cabrillo College for a day when I was in 4th grade. 
If you answered "Yes" to the previous question, did your Cabrillo College visit increase your understanding of college?
I know the education and training needed to accomplish my career goal.
Students are required to take and pass the A-G courses to attend a California 4-year university. 
CSUs and UCs require foreign language classes to be eligible for admission.
Grants and scholarships are sort of like "free money" to help pay for college.

Question Title

* 18. What do you hope to learn at your university visit?

T