* 1. Name

* 2. Campus:

* 3. Affiliate School

* 4. Career program at Great Oaks

* 5. Grade level

* 6. When did you first consider withdrawing from Great Oaks?

* 7. Did you discuss alternatives to withdrawal with anyone on campus?

* 8. If "Yes", with whom?

For questions 8-11: What factors below influenced your decision to withdraw? Choose all that apply.

* 9. Social environment (choose all that apply)

* 10. Career program (choose all that apply)

* 11. Academic classes (choose all that apply)

* 12. Personal (choose all that apply)

* 13. Overall, how much of a factor were social issues in your decision not to stay?

* 14. Overall, how much of a factor was your career program in your decision not to stay?

* 15. Overall, how much of a factor were your academic classes in your decision not to stay?

* 16. Overall, how much of a factor were personal issues in your decision not to stay?

* 17. Are there any additional comments you would like to share with us?

Thank you for completing this survey.
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