Hello! It has been some time since your exchange experience. We would like to ask you some questions about the program and its impact on your life, since your return home. The information you provide will help us design programs that better meet the needs of our participants. Please know that your answers will be strictly confidential and will in no way affect your participation in the program. We will use the data for analytical and evaluative purposes only.
Please feel free to give us your honest opinions. This survey is not a test, and there are no right or wrong answers. Thank you for your participation in this survey.
Privacy Act and Paperwork Reduction Act Statements:
The information solicited on this survey is requested pursuant to the Government Performance and Results Act of 1993 (P.L. 103-62) and the Mutual Educational and Cultural Exchange Act of 1961, as amended, also known as the Fulbright-Hays Act (22 U.S.C. 2451, et seq.). In order to ensure that the U.S. Department of State’s international exchange programs meet statutory program requirements (22 U.S.C. 2460(c)), the Department’s Bureau of Educational and Cultural Affairs (ECA) regularly monitors the programs, gathers data about program accomplishments, and evaluates selected ones. ECA uses the information collected to inform program design, management, and funding. All personal information that is collected through surveys is considered confidential. All responses are coded to ensure the confidentiality of individual responses. Data collected under this study will not be shared, sold, or used for fundraising purposes. Survey data and findings will be used only in an aggregate form for the express purposes of fulfilling the data needs of the outcome assessment. Responses to this survey are voluntary.
Public reporting burden for this collection of information is estimated to average thirty (30) minutes to respond to this survey, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An Agency may not conduct or sponsor, and respondents are not required to respond to, a collection of information unless it displays a valid OMB control number. Please send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: A/ISS/DIR, U.S. Department of State, Washington, D.C. 20520.
Exchange programs provide participants with many important opportunities for learning and engaging people from other countries. In the table below, please select the 3 accomplishments that have had the most impact on your life, since your return home.
Achievements |
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Shared experience and learning about leadership |
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Shared experience and learning about community service |
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Increased my understanding of the U.S. and U.S. society, people, and culture |
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Increased my understanding of my field of study |
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Made friends with American students and their families |
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Shared my culture with others |
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Other? (Write in) |
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Please elaborate on the impact of any of these or other accomplishments, not listed above.
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Looking back, did the Eurasian Undergraduate Exchange program help you improve your own skills in these areas? Please check one box in each row.
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No, not at all |
A little |
Somewhat |
A good deal |
Leadership |
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Community service |
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English (reading, writing, speaking) |
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Computer (Internet, software programs) |
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Other: (please write in)
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If so, please give examples of how you have used these improved skills.
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Have you used the skills or experience gained during the program to do any of the following? Please check one box in each row.
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Yes |
No |
Participate in community service, if you hadn’t done so before your exchange. |
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Share leadership skills, if you hadn’t done so before your exchange. |
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Use leadership skills in various activities, if you hadn’t done so before your exchange. |
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Use knowledge gained during the exchange in your workplace. |
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To what extent are you involved in the following activities? Please check one box in each row.
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Not at all |
To a small extent |
To some extent |
To a great extent |
Community service |
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Civic or political activism |
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Cultural activities |
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Religious activities |
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Student clubs or organizations |
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Student journalism |
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NGO involvement |
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Other (please write in):
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With regard to the activities listed above (community service, civic or political activism, cultural activities, religious activities, student clubs or organizations, student journalism, NGO involvement or other), to what extent do you do the following? Please check one box in each row.
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Not at all |
To a small extent |
To some extent |
To a great extent |
I attend meetings. |
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I plan activities and events. |
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I lead activities and events. |
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I train other participants or members. |
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I serve in a leadership position. |
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I started a new group or organization. |
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Other (please write in):
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If you can, please describe some of your recent activities (for example, a recent event you attended or organized, or a project you worked on).
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Since the completion of your program, have you faced any obstacles in reaching or accomplishing your goals? Have you been able to surmount these? Please provide examples, as appropriate.
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As a direct result of your participation in the exchange program, have you done or received any of the following at school/university? Please check one box in each row.
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Yes |
No |
Higher level of responsibilities or leadership at school/university |
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Organized or initiated new activities or projects at school/university |
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Established a new organization at school/university |
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As a direct result of your participation in the exchange program, have you done or received any of the following in your community? Please check one box in each row.
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Yes |
No |
Assumed a leadership role or position in your community |
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Organized or initiated new activities or projects in your community |
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Established a new organization in your community |
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Have you used the knowledge or experience gained in the program to initiate any of these formal or informal changes in your organization or work? Please check one box in each row.
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Yes |
No |
Increased volunteer activities/community service |
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Founded an NGO or new organization |
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Introduced new ideas and knowledge |
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Introduced initiatives, new ways of doing things |
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Established new exchanges |
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Tried to influence public opinion about the United States through the media |
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Established joint ventures, organizational partnerships, or linkages |
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Introduced new policies or procedures |
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Introduced new curricula, pedagogical methods, or educational standards |
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Became elected or appointed to a local, regional or national government position |
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Proposed, wrote, and/or passed a new law or treaty |
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Below is a list of different skills and abilities a leader might have. Please rate yourself as either poor, fair, good or excellent on the following characteristics. Please check one box in each row.
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Poor |
Fair |
Good |
Excellent |
Being self-reliant, being independent, relying on yourself. |
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Speaking in public. |
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Listening to other people’s suggestions or concerns. |
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Expressing ideas and feelings. |
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Working closely with people different from you. |
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Leading a team and motivating others. |
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Being flexible. |
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Solving problems. |
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Planning for the future. |
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Managing your time. |
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Managing money. |
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Discussing your beliefs/values. |
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Willing to make changes in your community. |
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How much do you agree/disagree with the following statements about you as an individual? Please check one box in each row.
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Strongly disagree |
Somewhat disagree |
Neither agree nor disagree |
Somewhat agree |
Strongly agree |
I feel I have many choices in my life. |
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I feel I can make a difference in my family. |
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I feel I can make a difference in my community. |
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I feel I can influence people around me. |
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Upon reflection, what has participation in the program meant to you personally? (for example, how has your outlook changed and how have you expressed this?)
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Have you shared your program experience or the knowledge you gained during your exchange in any of the following ways? Please check box in each row.
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Yes |
No |
Participated in media interviews (newspaper, television, radio, internet) |
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Gave presentations to community, neighborhood, school or university groups |
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Wrote newspapers articles, including editorials and opinion pieces. |
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Wrote academic books |
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Wrote non-academic books |
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Wrote academic articles—for journals or academic publications |
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Other (please write in): |
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How do you view the United States government and its relationship with your home country?
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Strongly Disagree |
Disagree |
Neither Agree or Disagree |
Agree |
Strongly Agree |
The U.S. government is a trustworthy partner for my country. |
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How do you view the U.S. Government and the American people? (Please check one box in each row.)
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Strongly Unfavorable |
Generally Unfavorable |
Neither favorable or unfavorable |
Generally Favorable |
Strongly Favorable |
U.S. government |
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American people |
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To what extent do you agree or disagree with the statements below?
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Strongly Disagree |
Disagree |
Neither Agree nor Disagree |
Agree |
Strongly Agree |
Voting is important because real decisions are made in elections. |
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Free and fair elections are the cornerstone of democracy. |
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An independent media is important to the free flow of information. |
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All citizens in a country should have equal rights and protections under the law, regardless of circumstances. |
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The Rule of Law is fundamental to a functioning democracy. |
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Individuals and organizations have the right to free speech and to voice opposition. |
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Democratic principles enhance the workplace. Supervisors should incorporate democratic principles into their management practices. |
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Have you remained in remain in contact with people you met during your exchange program?
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Yes |
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No |
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If yes, with whom have you remained in contact? Please check one box in each row.
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Yes |
No |
U.S. students in the program |
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U.S. teachers in the program |
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U.S. family – home stay |
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Program staff in U.S. |
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Other program participants |
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Other students you met in the U.S. |
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Other: (please write in)
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Have you continued to study and learn about the country you visited?
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Yes |
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No |
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Do you plan to seek other opportunities for study abroad?
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Yes |
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No |
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Have you encouraged friends to travel or study abroad?
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Yes |
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No |
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Geographic location:
I live in… |
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My country’s capital city |
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Another major city in my country other than the capital |
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A small city, town or rural location in my country |
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Home country: [Drop Down List]
Date of birth (day/month/year) Ex: 20/10/1978: ____________________
Sex:
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Female |
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Male |
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Which language do you consider to be your native language/mother tongue? _____________
What religious group do you consider yourself a member of or feel closest to? (Please check one.)
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Bahai’ism |
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Judaism |
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Buddhism |
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Shintoism |
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Christianity |
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Sikhism |
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Confucianism |
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Taoism |
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Hinduism |
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Zoroastrianism |
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Islam |
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Not close to any group |
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Jainism |
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None |
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Other: (please write in)
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Do you know about and have you registered for the State Department Alumni website, https://alumni.state.gov?
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Yes, I know about it and I have registered |
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Yes, I know about it but I have not yet registered |
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Yes, I know about it but I do not plan to register |
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No, I do not know about it |
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We encourage you to visit the website!
Thank you for completing this survey! If you have additional comments you would like to make, please do so here.
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How long did it take you to complete this survey? ______minutes
OMB NO: 1405-0158
Control No. SV-2007-0015
Expiration Date: 02/29/08
Estimated Burden Time: 30 minutes
File Type | application/msword |
File Title | Linking Individuals, Knowledge, and Culture (LINC): |
Author | dingbat |
Last Modified By | Jill Tirnauer |
File Modified | 2007-06-06 |
File Created | 2007-04-16 |