Certificate Program Student Background Survey 100% of survey complete. Question Title * 1. Age Under 30 30-40 40-50 50-65 65+ Question Title * 2. What is the highest level of education completed? BA/BS BSW MSW BSN MSN JD MS in Gerontology Other (please specify) Question Title * 3. Have you taken a Brookdale Certificate Program course within the last 2 calendar years? Yes No (if no please continue to question 6) Question Title * 4. If yes, are you currently enrolled in a certificate program? Yes No Question Title * 5. If yes, which Certificate are you currently pursuing? (if answering yes, please skip to question 9) Certificate in Aging Certificate in Aging & Mental Health Certificate in Geriatric Care Management Question Title * 6. If no, are you a graduate of program? Yes No Question Title * 7. If you are a Brookdale Certificate Program graduate, which certificate did you receive? Certificate in Aging Certificate in Aging & Mental Health Certificate in Geriatric Care Management Other (please specify) Question Title * 8. When did you recieve your Brookdale Certificate? 2009 to present 2007-2009 2006-2004 2004-2002 Before 2002 I can't recall Question Title * 9. How did you hear about the Brookdale Certificate Programs? Through direct mail Through an email from the Brookdale Center Through an email from Continuing Education at Hunter Referred by a friend Other (please specify) Question Title * 10. Which of the following categories best describes your employment status? Employed, working with older adults Employed, working in an unrelated field Not employed, looking for work Not employed, NOT looking for work Retired Disabled, not able to work Other (please specify) Question Title * 11. How would you describe your experience with the program? Question Title * 12. Are there any programs or classes you would like to see? Question Title * 13. Would you be willing to share the following information with us? Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Question Title * 14. Would you like to be added to our mailing list? Yes No Done