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pdfOMB No:14050193
Expiration Date: 07/31/2017
Estimated Burden: 5 minutes
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EducationUSA is a U.S. Department of State network of advising centers that provide accurate, current and
comprehensive information on U.S. higher education opportunities. EducationUSA centers in India offer valuable
support to students, parents, and academics in the form of specialized and university sessions, education fairs, and
predeparture orientation.
We welcome your feedback on your higher education journey and engagement with EducationUSA in India. This voluntary survey will help us
improve services to better reach and inform Indians interested in studying in the United States.
The survey should take approximately 5 minutes to complete. At the end of the survey you will be given an option of registering for a separate,
voluntary predeparture orientation at one of our seven EducationUSA centers. Thank you!
1. Are you aware of EducationUSA?*
Yes
No
2. Have you visited EducationUSA online – www.educationusa.state.gov?*
Yes
No
3. Which of the following EducationUSA centers in India have you visited in person? (Check all that apply)*
Ahmedabad – EducationUSA @ IAES
Bangalore – EducationUSA @ Yashna Trust
Chennai – EducationUSA @ USIEF
Hyderabad – EducationUSA @ USIEF
Kolkata – EducationUSA @ USIEF
Mumbai – EducationUSA @ USIEF
New Delhi – EducationUSA @ USIEF
None
4. Within the last four years, have you had a membership to one of the EducationUSA centers and availed counseling services? (Check
all that apply)*
Ahmedabad – EducationUSA @ IAES
Bangalore – EducationUSA @ Yashna Trust
Bangalore – EducationUSA @ Yashna Trust
Chennai – EducationUSA @ USIEF
Hyderabad – EducationUSA @ USIEF
Kolkata – EducationUSA @ USIEF
Mumbai – EducationUSA @ USIEF
New Delhi – EducationUSA @ USIEF
None
5. EducationUSA has visited my school/university?*
Yes
No
Other:
Other or comment:
6. Have you attended an EducationUSA webinar?*
Yes
No
7. Which of the websites of our EducationUSA partners in India have you visited online? (Check all that apply)
http://www.iaesgujarat.org
http://www.yashnatrust.org
http://www.usief.org.in
8. Which of the following have you worked with to prepare for your higher education admissions? (Check all that apply)*
a. Paid Tutor to Prepare for Standardized Tests
b. Paid Counselor/Coach to Prepare Applications
c. Paid Agent Representing One or More Higher Education Institutions
d. University Representative
e. EducationUSA Advisor
f. School Counselor
g. Family Member
h. Friend or Classmate
i. None
Other:
9. What would you do to improve awareness and use of EducationUSA in India?
10. Which U.S. Embassy or Consulate General issued your U.S. visa?*
Embassy New Delhi
Consulate General Chennai
Consulate General Hyderabad
Consulate General Kolkata
Consulate General Mumbai
Student Profile and Details of Residence
11. Your latest/current academic qualification:*
Grade 12
Bachelors
Masters
PhD/Post Doctoral
Other professional degrees
Other:
12. Proposed Level of Study in the U.S.*
Bachelors
Masters
Doctorate
Integrated PhD
Post Doctoral Studies
Certificate/Short term Course
13. Which field/specialization are you admitted to in the U.S university/college?*
Please mention the specialized program/major that you plan to study in the U.S (Eg. Chemical Engineering/ Molecular Biology)
14. In which Indian City do you have your permanent address?*
a. State*
Andaman and Nicobar Islands
b. Pincode
15. Would you like to register for EducationUSA organized Predeparture Orientation?*
Yes
No
Please choose a center below and submit the form to proceed with the registrations. On submitting this form, you will be taken to the center specific PDO registration form for
each city which needs to be completed only once.
Public reporting burden for this collection of information is estimated to average 5 minutes per response, including time required for searching
existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final
collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments
on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: Matthew Asada (asadam@state.gov).
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| File Type | application/pdf |
| File Modified | 2016-05-13 |
| File Created | 2016-05-13 |