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pdfPeace Corps Conversion Loss
Final Questionnaire
4/22/11
SAMPLE REQUIREMENTS: [NO PAYMENT/INCENTIVE WILL BE PROVIDED]
Tag respondents based on sample:
Applicant
Returned volunteer
Introduction
Applicants:
Thank you for agreeing to take the Peace Corps survey and helping us inform our application process for
potential future Volunteers. It will only take 20-minutes to complete. The survey is designed to be
completed in a single session.
The Peace Corps abides by the OMB Paperwork Reduction Act.
(see link to OMB Paperwork Reduction Act for further guidance on paperwork reduction and privacy.)
Returned volunteers:
Thank you for agreeing to take the Peace Corps survey and helping us inform our application process for
potential future Volunteers. It will only take 20-minutes to complete. The survey is designed to be
completed in a single session.
The Peace Corps abides by the OMB Paperwork Reduction Act.
(see link to OMB Paperwork Reduction Act for further guidance on paperwork reduction and privacy.)
1
This section asks about your experience with the Peace Corps in general.
Section B – Introduction and Assessment of Peace Corps
1. [ASK ALL] When considering volunteering, what prompted you to inquire or
apply to Peace Corps? (Randomize, mark as many as apply)
a. Advertisement
b. Newspaper or magazine article
c. Television news story
d. Regional recruitment staff or event
e. Social media network or website (like Facebook)
f. School advisor or mentor
g. Family
h. Friends
i. Co-workers
j. Classmates
k. Current or returned Peace Corps volunteer
l. Other (please specify) [ANCHOR]
2. [ASK ALL] Which, if any, of the following people, whom you know
personally, are current or past Peace Corps volunteers? (Randomize, mark as
many as apply)
a. Family
b. Friends
c. Co-workers
d. Classmates
e. Teacher, school advisor or mentor
f. Other, specify [ANCHOR]
g. I do not personally know any current or past Peace Corps volunteers
[ANCHOR]
3. [ASK ALL] What is your overall opinion of the Peace Corps? Would you say it
is…? (Mark one response)
a. Very favorable
b. Somewhat favorable
c. Somewhat unfavorable
d. Very unfavorable
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4. [ASK ALL] People consider the Peace Corps for many reasons. How
important were the following factors in learning more about Peace Corps?
(Mark one response for each)
Randomize
Very
important
Somewhat
important
Slightly
important
Not at all
important
Don’t
know
Very
important
Somewhat
important
Slightly
important
Not at all
important
Don’t
know
Very
important
Somewhat
important
Slightly
important
Not at all
important
Don’t
know
Experiencing a
different culture
Work
experience
Helping others
International
experience
Learning a new
language
Personal growth
State of the
U.S. job market
Serving my
country
Traveling or
adventure
Following in the
footsteps of
others, like
family or friends
Making a
difference in the
world
Other, specify
[ANCHOR]
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5. [ASK APPLICANT ONLY] How informed do you feel about Peace Corps
volunteering? (Mark one response)
a. Very informed
b. Somewhat informed
c. Slightly informed
d. Not at all informed
6. [ASK APPLICANT ONLY] Which of the following areas of work were you most
interested in exploring with the Peace Corps? (Randomize, mark as many as
apply)
a. Education
b. Youth and Community Development
c. Health and HIV/AIDS
d. Business and Information & Communication Technology
e. Agriculture
f. Environment
g. Other (please specify) [ANCHOR]
h. None of these [ANCHOR]
7. [ASK APPLICANT ONLY] Overall, did you get enough information about the
area of work you were most interested in? (Mark one response)
a. Yes
b. No
c. Don’t know
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8. [ASK APPLICANT ONLY] How informed were you about each of the following
aspects of the Peace Corps process and what it takes to become or be a
volunteer? (Mark one response for each)
Randomize
Very
informed
Somewhat
informed
Slightly
informed
Not at all
informed
Don’t
know
Very
informed
Somewhat
informed
Slightly
informed
Not at all
informed
Don’t
know
The application
process
The requirements of
becoming a
volunteer
The medical
clearance process
The
legal/background
check clearance
process
The references
needed
The length of time
the application
process takes
The length of the
volunteer
assignment
Randomize
What Peace Corps
provides while in
service
How much money
you receive after
completing your
assignment
Training provided
by Peace Corps
How Peace Corps
matches you to a
country
5
The work you would
do in your country
of assignment
Randomize
Very
informed
Somewhat Slightly
informed
informed
Not at all
informed
Don’t
know
9. [ASK APPLICANT ONLY] Which of the following did you complete in inquiring
or applying for the Peace Corps? (Mark all that apply)
a. I attended a Recruitment Information session, but did not start the
application
b. I completed the initial online application questionnaire but did not
start the online application
c. I started the online application but did not submit it
d. I completed the online application but then notified the Peace Corps
that I wanted to withdraw
e. I completed the online application but then decided that I did not want
to move forward. I did not notify the Peace Corps.
10.[IF Q13 D OR E SELECTED] From the time you decided you were interested
in Peace Corps, how long before you started your application? (Mark one
response)
a. Immediately
b. Less than 1 month
c. 1 month to less than 3 months
d. 3 months to less than 6 months
e. More than 6 months
11.[IF Q13 D OR E SELECTED] Which of the following did you complete after
submitting your application? (Mark all that apply)
a. I submitted the “legal kit” including: finger prints, National Agency
Check (NAC) questionnaire
b. My three references were submitted
c. I interviewed
d. I was nominated
e. I received the medical kit and underwent the medical clearance
process
f. I was medically and legally cleared
g. I was invited to serve as a Peace Corps Volunteer
h. I accepted the invitation
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i. I completed visa and passport forms
12.[ASK APPLICANT ONLY] To what extent did any of the following requirements
deter you from becoming a volunteer? (Mark one response for each)
Randomize
A great
deal
Some
Not much
Not at all
Don’t
know
A great
deal
Some
Not much
Not at all
Don’t
know
The medical kit
clearance process
The
legal/background
check kit clearance
process
Completion of the
three references
needed
The interview needs
The visa and/or
passport needs
Randomize
13.[IF Q13 D OR E SELECTED OR RETURNED VOLUNTEER] Overall, how satisfied
were you with the Peace Corps application process? (Mark one response)
a. Very satisfied
b. Somewhat satisfied
c. Somewhat dissatisfied
d. Very dissatisfied
14.[ASK APPLICANT ONLY] What made you [A. satisfied/B. dissatisfied] with the
Peace Corps application process? Please be as specific as possible. (openend, verbatim only, not coded)
7
15. [IF Q13=D OR E SELECTED] To what extent do you agree or disagree with
the following statements about the online application process? (Mark one
response for each)
Randomize
Strongly
agree
Somewhat
agree
Somewhat
disagree
Strongly
disagree
Don’t
know
Strongly
agree
Somewhat
agree
Somewhat
disagree
Strongly
disagree
Don’t
know
Is easy to
understand
Is easy to
navigate
Experienced
technical
problems
Provides you
with good
instructions on
the information
needed to
complete the
application
Takes too long
to complete
Randomize
Requires too
much
information
Completing the
essay portions
delayed or
otherwise
impacted my
application
submittal
.
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16.[IF Q13 D OR E SELECTED] To what extent do you agree or disagree with the
following statements about the consideration process following the online
application completion? (Mark one response for each)
Randomize
Strongly
agree
Somewhat
agree
Somewhat
disagree
Strongly
disagree
Don’t
know/does
not apply
I thought
completing the
legal kit was
straightforward
I thought the
legal and
background
clearance was
thorough
I thought
completing
references
online was
convenient
I thought
scheduling and
completing the
interview with
my recruiter
was simple
I thought
understanding
the nomination
process was
clear
I thought the
medical
clearance was
thorough
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I thought the
medical
clearance was
straightforward
Randomize
Strongly
agree
Somewhat
agree
Somewhat
disagree
Strongly
disagree
Don’t
know
Strongly
agree
Somewhat
agree
Somewhat
disagree
Strongly
disagree
Don’t
know
I thought it was
easy to
understand the
invitation
process
I was aware
that I would
need to pay for
additional
medical
expenses
My Recruiter
was helpful and
accessible
My Placement
Officer was
helpful and
accessible
Randomize
10
17. [ASK APPLICANT ONLY] What made you change your mind and not want to
pursue the Peace Corps? (Randomize, mark as many as apply)
a. Financial situation improved
b. Financial situation worsened
c. My student loans could not be deferred
d. Got a job
e. Went back to school
f. Relationship issues
g. Family situation
h. Have not traveled a lot on my own
i. Concern about isolation
j. Concern for my safety
k. Concern for my health
l. Concern over not getting the work assignment I wanted
m. Concern over not being placed in the country I wanted
n. Concern over the length of the application process
o. Concern over the length of the 27 month commitment to the volunteer
assignment
p. Concern that I wouldn’t get the experience I wanted
q. Concern that I wouldn’t gain the skills I wanted
r. Concern that it would be harder to enter / re-enter the workforce after
the assignment
s. Concern that I would miss home
t. I decided that Peace Corps was not the right fit for me
u. Other, specify [ANCHOR]
v. None of these [ANCHOR]
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18.[ASK APPLICANT ONLY] Which, if any, of the following information would
have made you more willing to continue with your Peace Corps volunteer
consideration? (Randomize, mark as many as apply)
a. Understanding more about paid living expenses
b. Understanding more about the program completion pay
c. Knowing more about program assignments
d. Having more information about what Peace Corps provides in terms of
safety and security
e. Personal contact with Peace Corps staff during the application process
f. Talking to current or returned volunteers about their experience
g. Having someone help me with the application process
h. Better understanding about the length of the application process
i. Understanding more about the length of the volunteer assignment
j. Knowing there would be work placement support after completing the
program
k. Having more control over the region of placement
l. Having more control over the volunteer assignment
m. Gaining a better understanding of the career benefits of Peace Corps
n. Getting guidance about how to deal with student loans while in the
application process
o. Getting guidance on how to deal with personal debt while in the
application process
p. Getting more information on Peace Corps graduate school
partnerships
q. Other, specify [ANCHOR]
r. None of these [ANCHOR]
19. [ASK ALL] How likely are you to recommend others apply to the Peace
Corps? (Mark one response)
a. Very likely
b. Somewhat likely
c. Somewhat unlikely
d. Very unlikely
20. [ASK ALL] What makes you [A. likely/B. unlikely] to recommend others
apply to the Peace Corps? Please be as specific as possible. (open-end,
verbatim only, not coded)
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Section C – Volunteering Behaviors
21. [ASK ALL] In which of the following areas have you volunteered or helped
others in the past? (Randomize, mark as many as apply)
a. Political
b. Professional
c. Educational, literacy
d. Youth
e. Environmental or animal care
f. Hospital or other health
g. Public safety
h. Religious/spiritual
i. Social or community service
j. Sports
k. Hobby, cultural or arts
l. Helping neighbors
m. International
n. Other, specify [ANCHOR]
o. I have no prior experience with volunteering or helping others
[ANCHOR]
22.[ASK ALL] Which of the following best describes your experience traveling?
(Mark as many as apply)
A. Domestic Travel
a. I’ve traveled as a tourist
b. I’ve studied in different parts of the US
c. I’ve worked in different parts of the US
d. I’ve not traveled domestically
B. International Travel
a. I’ve traveled internationally as a tourist
b. I’ve studied overseas
c. I’ve worked overseas
d. I’ve not traveled internationally
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Section D – Final Demographics
We just have a few more questions. These will be used for classification purposes
only.
23. [ASK ALL] Which of the following best describes your education status at the
time of your application to the Peace Corps? (Mark one response)
a. Full-time student
b. Part-time student
c. Not currently in school
24. [ASK ALL] What is the highest level of education you completed at the time
of your application to the Peace Corps? (Mark one response)
a. Did not complete high school
b. High school graduate / GED
c. Technical school graduate
d. One or two years of college completed
e. A.A. degree or equivalent
f. Third year of college completed
g. College graduate
h. Some graduate study completed
i. Graduate Degree
25.[ASK ALL] Were you employed at the time of your application?(Mark one
response)
a. Full time (work 35 hours or more a week at all jobs)
b. Part time (less than 35 hours a week at all jobs)
c. Not employed
26.[IF EMPLOYED] In which type of organization were you employed at the time
of your application? (Mark one response)
a. Public for-profit company, business or individual
b. Private for-profit company, business or individual
c. Private nonprofit, tax-exempt, or charitable organization
d. Local government agency
e. State government agency
f. Federal government agency
g. Self-employed in own or family business, professional practice or farm
h. Other, specify [ANCHOR]
14
27.[IF NOT EMPLOYED (Q28 = C) OR NOT IN SCHOOL (Q26 = C)] You indicated
that you were not employed or going to school at the time of your application
to the Peace Corps. Which of the following describe what you were doing at
the time of your application? (Randomize, mark as many as apply)
a. Volunteering
b. Traveling
c. Looking for work
d. Retired
e. Managing a household
f. Other, specify [ANCHOR]
The next few questions relate to financial status and student loans. Peace Corps
needs to ask these questions to determine the extent to which financial concerns
are a barrier to pursuing Peace Corps.
28. [ASK ALL] Which of the following best describe you at the time of your
application to the Peace Corps? (Mark one response)
a. I have my own personal income and do not rely on financial support
from others
b. I have my own personal income, but also rely on financial support
from others
c. I do not have my own personal income, and rely on others for support
29.[IF 31= A OR B] At the time of your application, what was your total personal
annual income, before taxes? By income, we mean wages, salary,
commissions, bonuses, tips, interest, dividends, royalties, disability, public
assistance or other earned income. (Mark one response)
a. Under $15,000
b. $15,000 to $25,000
c. $25,000-$49,999
d. $50,000-$74,999
e. $75,000-$99,999
f. $100,000-$124,999
g. $125,000-$149,999
h. $150,000 or more
i. I still rely on financial support from others
j. Decline to answer
15
30.[ASK ALL] [IF 31= B OR C] At the time of your application, if you were
relying on other (family, student loans, etc…) support, what was your
household income? (Mark one response)
a. Under $15,000
b. $15,000 to $25,000
c. $25,000-$49,999
d. $50,000-$74,999
e. $75,000-$99,999
f. $100,000-$124,999
g. $125,000-$149,999
h. $150,000 or more
i. Don’t know
j. Decline to answer
31. [ASK ALL] At the time of your application to the Peace Corps, how much did
you owe in student loans? (Mark one response)
d. Under $10,000
e. $10,000-$20,000
f. $20,000-$30,000
g. $30,000-$40,000
h. $40,000-$50,000
i. Over $50,000
j. I did not have any outstanding student loans
k. Don’t know
32. [ASK ALL] How well does each of the following statements describe you at
the time of your application? (Mark one response for each)
Randomize
Very well
Somewhat
well
Slightly
well
Not well
at all
Don’t
know
I was living
paycheck to
paycheck
I had financial
debt (other
than student
loans) that
influenced the
job choices I
16
made
I was
considering
going back to
school
I was having a
hard time
finding a job
I needed to find
ways to make
myself more
marketable in
the job market
I was looking to
make a change
in my job or my
life
Randomize
Very well
Somewhat Slightly
well
well
Not well
at all
Don’t
know
33. [ASK ALL] At the time of your application to the Peace Corps, what was your
marital status? (Mark one response)
a. Single, never married
b. Engaged
c. Living with a partner
d. Married
e. Separated
f. Divorced
g. Widowed
34. [ASK ALL] What is the zip code for where you went to college most recently?
[Code to regions: Northeast, Midwest, South, West][Provide don’t know
option]
35. [ASK ALL] What is your home or residential zip code? [Code to regions:
Northeast, Midwest, South, West] [Provide don’t know option]
17
Finally, we’d like to ask you a few questions for classification purposes only.
Section A – Demographics
36. [ASK ALL] What is your gender? (Mark one response)
a. Male
b. Female
37.[ASK ALL] What is your age? Please enter in the box below. (Enter exact
below, code back to ranges)
[___________]
a.
b.
c.
d.
e.
f.
18 to 21
22-24
25-29
30- 39
40- 49
50+
38.[ASK ALL] Which of the following best describes your ethnicity? (Mark one
response)
a. Hispanic or Latino (Of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of race)
b. Not Hispanic or Latino
39.[ASK ALL] Which of the following best describes your race? (Mark one or
more)
a. American Indian or Alaska Native
b. Asian
c. Black or African American
d. Native Hawaiian or Other Pacific Islander
e. White
18
Thank you so much for completing this survey. Your feedback is very important to
us.
Provide link to Peace Corps /OMB PRA (Paperwork Reduction Act):
OMB control number: 0420-####. The Peace Corps Act (22 USC § 2501 et seq.) authorizes this
collection of information. It will be used to collect feedback from Peace Corps applicants and
returned Volunteers to help understand factors that are driving recruitment attrition, as well as what
information or education needs would increase the conversion ratio. Providing the information
requested is voluntary. The Peace Corps may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB
control number. The time required to complete this information collection is estimated to
average 20 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments on this form to Peace Corps, Privacy
Act Office, 1111 20th Street, NW, Washington, DC 20526.
19
File Type | application/pdf |
File Title | UnitedHealthcare Volunteering and Health Survey |
Author | clusterny |
File Modified | 2011-04-28 |
File Created | 2011-04-28 |