Download:
pdf |
pdfOMB #0925-XXXX
EXP. XX/XXXX
Attachment 8b:
HERI Freshman Survey (Paper Version)
CO
OOPERATIIVE INSTIITUTIONA
AL RESEA
ARCH PRO
OGRAM (C
CIRP) FRE
ESHMAN
SU
URVEY IN
NFORMAT
TION SHE
EET
Univ
versity off California
a, Los Ang
geles
Purp
pose of the
e Study
You aare asked to
o complete this survey as part of a national sttudy condu
ucted by thee Higher
Educcation Reseearch Institu
ute (HERI) at the Univ
versity of Caalifornia, Lo
os Angeles. This study is
desig
gned to deteermine wha
at happens to
t students when they attend colllege. Since1966, over 115
million studentss at over 1,9
900 collegess and universities havee participateed in this reesearch. The
data gathered arre used in studies desig
gned to bettter understtand studen
nt learning aand
development an
nd to help im
mprove the quality of college
c
educcation.
Proc
cedures
To paarticipate in
n this study
y, please com
mplete and submit thee following ssurvey. Most
respo
ondents com
mplete this questionna
aire in abou
ut 45 minuttes, althouggh individuaal progress will
vary by how quiickly you move
m
through
h the questiions.
You may decided not to complete the survey for any reason at any time without consequence of any kind.
The Higher Education Research Institute does not offer payment for participation. Your participation and
responses to the questionnaire indicate your consent to participate in the study. We ask for your name and
address so that the researchers at UCLA can contact you at some later data for follow-up study.
Pote
ential Benefits to Su
ubjects and
d/or Socie
ety
You may have the opportunity to reflect on your prior academic experiences and your expectations for
college as you complete the survey, which may enhance self-understanding. Your responses to the survey
also will be directly beneficial to your college or university, and may benefit future generations of college
students as well.
Pote
ential Risk
ks and Discomforts
Therre could be survey
s
item
ms that you are
a uncomffortable ansswering or tto which yo
ou would sim
mply
prefeer not to resspond. You
ur participattion in this study is strrictly volunttary, and yo
ou will be u
under
no ob
bligation wh
hatsoever to
t answer an
ny question
ns that you aare not incllined to ansswer. You m
may
choo
ose not to an
nswer any specific
s
questions you do
d not wantt to answerr and still reemain in the
studyy.
Information Protection
Please note that your responses will be used for research purposes only and will be protected.
Any information that is obtained in connection with this study and that can be identified with you will be
protected and secure to the extent permitted by law. Your identified responses will be returned to your
institution for institutional assessment purposes. Before receiving any responses your school
is required to certify in advance that the data are to be used for research purposes only and will not be used
to investigate specific individuals. Names and addresses will not be returned to your institution, however
Student ID numbers will be included in the final data file to allow your institution to merge responses with
other campus data.
Iden
ntification
n of investiigators
If you
u have any questions or
o concerns about the research,
r
pllease contacct the Manaaging Directtor of
HER
RI, Dr. Kevin
n Eagan at this
t addresss:
Hig
gher Educattion Researcch Institutee
UCLA Grad
duate Schoo
ol of Educattion and Infformation S
Studies Boxx 951521
Los Angelees, CA 9009
95-1521
Email: heri@ucla..edu
Phone:: 310-825-19
925
Righ
hts of Rese
earch Subjjects
You m
may withdrraw your consent at anyy time and discontinuee participattion withoutt penalty. Y
You are not
waiviing any lega
al claims, riights or rem
medies becau
use of your participation in this reesearch study. If you
have questions regarding
r
your
y
rights as
a a researcch subject, ccontact the U
UCLA Officce for Protecction of
Reseearch Subjeccts, 11000 Kinross
K
Aveenue, Suite 102,
1
Box 9551694, Los A
Angeles, CA
A 90095-169
94, (310)
825-7122.
g burden fo
or this collecction of info
formation iss estimated
d to averagee 45 minutees per
Public reporting
respo
onse, includ
ding the tim
me for revieewing instru
uctions, seaarching exissting data ssources, gatthering and
d
main
ntaining thee data needed, and com
mpleting an
nd reviewin
ng the collecction of info
ormation. A
An agency
may not conducct or sponso
or, and a peerson is nott required to
o respond tto, a collecttion of inforrmation unlless
it dissplays a currrently valid
d OMB conttrol numbeer. Send com
mments reggarding this burden esstimate or any
a
otherr aspect of this
t
collectiion of inforrmation, inccluding sugggestions fo
or reducing this burden
n, to: NIH,
Projeect Clearance Branch, 6705 Rock
kledge Drivee, MSC 7974
4, Bethesdaa, MD
2089
92-7974, AT
TTN: PRA (0925-xxxx
(
x*). Do not return the completed form to thiis address.
`
`
Yes
No
53. What is your best guess as to
the chances that you will:
(Mark one for each item)
49. Do you have any of the following disabilities or
medical conditions? (Mark Yes or No for each item)
Yes
Learning disability (dyslexia, etc.).........................
Attention deficit hyperactivity disorder (ADHD).....
Autism spectrum disorder.....................................
Physical disability (speech, sight, mobility,
hearing, etc.).......................................................
Chronic illness (cancer, diabetes, autoimmune
disorders, etc.)....................................................
Psychological disorder (depression, etc.).............
Other.....................................................................
No
` `
` `
` `
` `
` `
` `
` `
50. Will you pursue a science-related research career?
(Mark one)
`
`
`
`
`
Definitely yes
Probably yes
Uncertain
Probably no
Definitely no
N No Chance
L Very Little Chance
S Some Chance
V Very Good Chance
Change major field......................................................................
Change career choice.................................................................
Participate in student government...............................................
Get a job to help pay for college expenses................................
Join a social fraternity or sorority................................................
Transfer to another college before graduating............................
Participate in volunteer or community service work....................
Seek personal counseling...........................................................
Communicate regularly with your professors..............................
Participate in student clubs/groups.............................................
Participate in a study abroad program........................................
Work on a professor’s research project......................................
Get tutoring help in specific courses...........................................
Take courses from more than one college simultaneously.........
Take a leave of absence from this college temporarily..............
Take a course exclusively online................................................
Vote in a local, state, or national election...................................
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
The remaining ovals are provided for questions specifically designed by your college rather than the Higher Education Research
Institute. If your college has chosen to use the ovals, please observe carefully the supplemental directions given to you.
54.
55.
56.
57.
ABCDE
ABCDE
ABCDE
ABCDE
58.
59.
60.
61.
62.
63.
64.
65.
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
66.
67.
68.
69.
ABCDE
ABCDE
ABCDE
ABCDE
70.
71.
72.
73.
ABCDE
ABCDE
ABCDE
ABCDE
THANK YOU!
© Prepared by the Higher Education Research Institute,
University of California, Los Angeles, California 90095-1521
4
Data Recognition Corp.-6G6144-15767-54321
9. From what high school did you graduate? 17. Please mark which of the following courses you
have completed:
Name of high school
YN Algebra II
YN Pre-calculus/Trigonometry
YN Probability & Statistics
City
State
YN Calculus
CORRECT MARK INCORRECT MARKS
YN AP Probability & Statistics
a~aa
aaaa
YN AP Calculus
10. Are you: (Mark all that apply)
A
B
YN AP Computer Science A
` White/Caucasian
Group Code
How many weeks this summer did you participate
18.
` African American/Black
in a bridge program at this institution?
` American Indian/Alaska Native
Your sex: ` Male
` Female
` 7+
` 0
` 3-4
` East Asian (e.g., Chinese, Japanese,
1-2
5-6
Korean, Taiwanese)
`
`
Is English your primary language?
Filipino
`
During
high
school
(grades 9-12) how many years
19.
Yes
No
`
`
Southeast Asian (e.g., Cambodian,
did you study each of the following subjects?
`
In what year did you graduate from
Vietnamese, Hmong)
(Mark one for each item)
high school? (Mark one)
South
Asian (e.g., Indian, Pakistani,
`
Nepalese, Sri Lankan)
` Did not graduate but
` 2016
Mathematics.................... ```````
passed G.E.D. test
2015
`
` Other Asian
Foreign Language........... ```````
` Never completed
` 2014
` Native Hawaiian/Pacific Islander
Physical Science............. ```````
high
school
` 2013 or earlier
` Mexican American/Chicano
Biological Science........... ```````
Are you enrolled (or enrolling) as a:
` Puerto Rican
History/Am. Gov’t............ ```````
(Mark one)
` Other Latino
` Full-time student
Computer Science........... ```````
` Other
` Part-time student
Arts and/or Music............ ```````
11. Prior to this term, have you ever taken
How many miles is this college from
20.
How many Advanced Placement/International
courses for credit at this institution?
your permanent home? (Mark one)
Baccalaureate courses did you take in high school?
` Yes
` No
(Mark one in each row)
` 5 or less ` 11-50 ` 101-500
3.
4.
5.
4
2.
5o
morre
1.
MARKING DIRECTIONS
• Use a black or blue pen.
• Fill in your response completely.
Mark out any answer you wish to
change with an “X”.
Over 500 12. Since leaving high school, have you ever
taken courses, whether for credit or not
6. What was your average grade in high
for credit, at any other institution
school? (Mark one)
(university, 4- or 2-year college, technical,
vocational, or business school)?
` C
` A or A+ ` B
AP Courses........................... ``````
` D
` A–
` B–
` Yes
` No
IB Courses............................. ``````
13. To how many colleges other than this one
` B+
` C+
21.
Please refer to the same Parent/Guardian
did you apply for admission this year?
7. What were your scores on the SAT I
throughout this survey. Please mark the sex of
` 11 or
` None ` 3 ` 6
and/or ACT?
your parent(s) or guardian(s).
more
Male Female
4 ` 7-8
1
`
`
SAT Reading and Writing....
5
9-10
2
Parent/Guardian
1............................
` `
`. `
`
Parent/Guardian 2............................ ` . `
14. Were you accepted by your first choice
SAT Mathematics................
college? ` Yes
` No
22. At any time since you turned 13, were you in foster
care or were you a dependent of the court?
15.
Is
this
college
your:
(Mark
one)
ACT Composite........................
` Yes ` No
` I don’t know
` First choice
` Third choice
8. Where do you plan to live during the fall
you consider yourself: (Mark Yes or No for
` Second choice ` Less than third choice 23. Do
term? (Mark one)
each item)
Yes
No
16. Citizenship status: (Mark one)
` With my family or other relatives
Pre-Med............................................ ` . `
Other
private
home,
apartment,
or
room
U.S.
citizen
`
`
Pre-Law............................................ ` . `
College residence hall
Permanent resident (green card)
`
`
`
`
`
6-10
`
51-100
`
Fraternity or sorority house
Other campus student housing
Other
`
`
`
International student (i.e., F-1, J-1, or
M-1 visa)
None of the above
15+
48. Do you identify as transgender?
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EMAIL (print letters carefully):
3
Bisexual
Queer
Other
EVSN
EVSN
COUNTRY,
if NOT USA:
10-14
`
`
`
STUDENT ID# (as instructed):
ZIP:
2
Heterosexual/Straight
Gay
Lesbian
Becoming accomplished in one of the performing arts
(acting, dancing, etc.)...............................................................
Becoming an authority in my field..............................................
Obtaining recognition from my colleagues for contributions
to my special field....................................................................
Influencing the political structure................................................
Influencing social values............................................................
Raising a family..........................................................................
Being very well off financially.....................................................
Helping others who are in difficulty............................................
Making a theoretical contribution to science..............................
Writing original works (poems, novels, etc.)..............................
Creating artistic works (painting, sculpture, etc.).......................
Becoming successful in a business of my own..........................
Becoming involved in programs to clean up the environment...
Developing a meaningful philosophy of life................................
Participating in a community action program.............................
Helping to promote racial understanding...................................
Keeping up to date with political affairs.....................................
Becoming a community leader...................................................
Improving my understanding of other countries and cultures....
Integrating spirituality into my life...............................................
STATE:
5-9
6+
47. What is your sexual orientation?
`
`
`
CITY:
Year
Day
(01-31)
1
` 2 ` 3 ` 4 ` 5 `
` I do not plan to graduate from this college.
N Not Important
S Somewhat Important
Month
(01-12)
ADDRESS:
1-4
None
ROTC, cadet, or midshipman at a service academy
In the Reserves or National Guard
On Active Duty
A discharged veteran NOT serving on Active Duty,
in Reserves, or in National Guard
1
54321
54321
54321
NAME:
V Very Important
E Essential
46. How many years do you expect it will take you to
graduate from this college?
`
54321
When were you born?
1/2
52. Please indicate the importance to you
personally of each of the following:
(Mark one for each item)
45. Military Status: (Mark one)
`
`
`
`
`
I have a strong sense of belonging to a community
of scientists..............................................................
I derive great personal satisfaction from working
on a team that is doing important research.............
I think of myself as a scientist....................................
I feel like I belong in the field of science....................
PLEASE PRINT IN ALL CAPS YOUR NAME AND PERMANENT/HOME ADDRESS (one letter or number per box).
FIRST
MI
LAST
None
````````
````````
````````
````````
````````
````````
4 Agree Somewhat
5 Strongly Agree
24. Below is a list of different undergraduate major fields grouped
into general categories. (Fill in appropriate two-digit code on
your survey)
Not o
my h ffered at
igh s
choo
None
l
Over
20
16-20
11-15
6-10
3-5
````````
````````
2016 CIRP Freshman Survey
51. To what extent are the following
1 Strongly Disagree
statements true of you:
2 Disagree Somewhat
(Mark one in each row)
3 Neutral
SERIAL #
Studying/homework....................
Socializing with friends in person..
Online social networks
(Facebook, Twitter, etc.)...........
Partying......................................
Student clubs/groups..................
Exercise or sports......................
Working (for pay)........................
Household/childcare duties........
1-2
Hours per week:
Less
None
than
1 hou
r
44. During your last year in high school, how much time
did you spend during a typical week doing the
following activities?
ARTS AND HUMANITIES
01 Art, fine and applied
02 English (language and literature)
03 History
04 Journalism/Communication
05 Classical and Modern
Languages and Literature
06 Media/Film Studies
07 Music
08 Philosophy
09 Theatre/Drama
10 Theology/ Religion
11 Other Arts and Humanities
BIOLOGICAL & LIFE
SCIENCES
12 Biology (general)
13 Animal Biology (zoology)
14 Ecology & Evolutionary
Biology
15 Marine Biology
16 Microbiology
17 Molecular, Cellular, &
Developmental Biology
18 Neurobiology/Neuroscience
19 Plant Biology (botany)
20 Agriculture/Natural Resources
21 Biochemistry/Biophysics
22 Environmental Science
23 Other Biological Science
BUSINESS
24 Accounting
25 Business Admin. (general)
26 Entrepreneurship
27 Finance
28 Hospitality/Tourism
29 Human Resources Management
30 International Business
31 Marketing
32 Management
33 Computer/Management
Information Systems
34 Real Estate
35 Other Business
EDUCATION
36 Elementary Education
37 Music/Art Education
38 Physical Education/Recreation
39 Secondary Education
40 Special Education
41 Other Education
HEALTH PROFESSIONS
55 Clinical Laboratory Science
56 Health Care Administration/
Studies
57 Health Technology
58 Kinesiology
59 Nursing
60 Pharmacy
61 Therapy (occupational,
physical, speech)
62 Other Health Profession
MATH AND COMPUTER
SCIENCE
63 Computer Science
64 Mathematics/Statistics
65 Other Math and Computer
Science
PHYSICAL SCIENCE
66 Astronomy & Astrophysics
67 Atmospheric Sciences
68 Chemistry
69 Earth & Planetary Sciences
70 Marine Sciences
71 Physics
72 Other Physical Science
SOCIAL SCIENCE
73 Anthropology
74 Economics
75 Ethnic/Cultural Studies
76 Geography
77 Political Science (gov’t.,
international relations)
78 Psychology
79 Public Policy
80 Social Work
81 Sociology
82 Women’s/Gender Studies
83 Other Social Science
OTHER MAJORS
84 Architecture/Urban Planning
85 Criminal Justice
86 Library Science
87 Security & Protective
Services
88 Military Sciences/
Technology/Operations
89 OTHER
90 UNDECIDED
ENGINEERING
42 Aerospace/Aeronautical/
Astronautical Engineering
43 Biological/Agricultural
Engineering
44 Biomedical Engineering
45 Chemical Engineering
46 Civil Engineering
47 Computer Engineering
48 Electrical/ Electronic/
Communications Engineering
49 Engineering Science/
Engineering Physics
50 Environmental/Environmental
Health Engineering
51 Industrial/Manufacturing
Engineering
52 Materials Engineering
53 Mechanical Engineering
54 Other Engineering
24. Please indicate your intended major using the
codes provided on the
attached fold out.
Turn over for Question 25
1
Carefully detach this section after
answering Questions 24 and 25
`
`
`
`
`
29. What is your best estimate of your parents’/
guardians’ total income last year? Consider
income from all sources before taxes. (Mark one)
`
`
`
`
`
`
Less than $15,000
$15,000-24,999
$25,000-29,999
$30,000-59,999
$60,000-74,999
$75,000-99,999
`
`
`
`
`
`
$100,000-124,999
$125,000-149,999
$150,000-199,999
$200,000-249,999
$250,000-499,999
$500,000 or higher
30. Please select how many individuals in your
household (including yourself) are dependent on
your parent(s)/guardian(s) for financial support.
(Mark one)
`
I am not dependent on
my parent(s)/guardian(s)
`
`
1
2
`
`
`
`
3
4
5
6 or more
34. In the past year, how often
have you: (Mark one for each
item)
Attended a religious service.......
Been bored in class....................
Demonstrated for a cause (e.g.,
boycott, rally, protest)..............
Tutored another student.............
Studied with other students........
Consumed beer..........................
Consumed wine or liquor...........
2
...
...
`
`
FON
FON
FON
FON
FON
FON
FON
Critical thinking skills...
Ability to manage your
time effectively..........
s
`````
`````
36. What is the highest level of formal
education obtained by your parents/
guardians? (Mark one in each column)
Parent/
Guardian 1
Junior high/Middle
school or less...............
Some high school...........
High school graduate.....
Postsecondary school
other than college........
Some college..................
College degree...............
Some graduate school...
Graduate degree............
Parent/
Guardian 2
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
FON
FON
FON
Not at
All
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
39. How would you characterize your political
views? (Mark one)
`
`
`
Far left
Liberal
Middle-of-the-road
`
`
Conservative
Far right
40. In deciding to go to college, how
important to you was each of the
following reasons? (Mark one
answer for each possible reason)
To be able to get a better job.....................
To gain a general education and
appreciation of ideas................................
To make me a more cultured person.........
To be able to make more money...............
To learn more about things that interest
me............................................................
To get training for a specific career...........
To prepare myself for graduate or
professional school..................................
To please my family...................................
VSN
VSN
VSN
VSN
VSN
VSN
Averag
e
Averag
e
Below
Averag
e
Lowes
t 10%
t 10%
Above
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
1 Strongly Disagree
2 Disagree Somewhat
hat
Modera
tely
FON
FON
Highes
Not at
All
ntly
ionally
Oc c a s
Freque
FON
FON
Somew
tely
Very
Absolu
Not at
All
ntly
`
`
`
`
`
`
`
`
Oc c a s
Freque
...
...
...
...
...
.
...
.
...
...
e
Somew
hat We
ak
A Majo
r Weak
nes
Parent/
Guardia
Parent/ n 1
Guardia
n2
Yours
None........................................... `
Vocational certificate.................. `
Associate (A.A. or equivalent).... `
Bachelor’s (B.A., B.S., B.D., etc.).. `
Master’s (M.A., M.S., M.B.A., etc.).. `
J.D. (Law)................................... `
M.D., D.D.S., D.V.M., etc. (Medical).. `
Ph.D........................................... `
Professional Doctorate (Ed.D.,
Psy.D., etc.).............................. `
Other.......................................... `
FON
41. Rate yourself on each of the following
traits as compared with the average
person your age. We want the most
accurate estimate of how you see
yourself. (Mark one in each row)
Academic ability.......................................
Artistic ability............................................
Compassion.............................................
Creativity..................................................
Drive to achieve.......................................
Emotional health.......................................
Leadership ability.....................................
Mathematical ability..................................
Physical health.........................................
Public speaking ability..............................
Risk-taking................................................
Self-confidence (intellectual).....................
Self-confidence (social)............................
Spirituality.................................................
Understanding of others...........................
Writing ability............................................
42. Mark one in each row:
3 Agree Somewhat
4 Strongly Agree
Wealthy people should pay a larger share of taxes than they do now...............
Addressing global climate change should be a federal priority..........................
The federal government should have stricter gun control laws..........................
Affirmative action in college admissions should be abolished............................
The federal government should raise taxes to reduce the deficit.......................
Sexual activity that occurs without the presence of explicit, affirmative
consent (i.e., “yes means yes”) is considered sexual assault..........................
There is little that a person can do to be better at math – you are either
“good” or “bad” at math.....................................................................................
Intelligence is something that can be improved by studying or working harder..
4321
4321
4321
4321
4321
4321
4321
4321
43. Below are some reasons that might have influenced your decision to
attend this particular college. How important was each reason in your
decision to come here? (Mark one answer for each possible reason)
My parents/relatives wanted me to come here......................................................
My teacher advised me..........................................................................................
This college has a very good academic reputation................................................
This college has a good reputation for its social and extracurricular activities......
I was offered financial assistance..........................................................................
The cost of attending this college..........................................................................
High school counselor advised me........................................................................
Private college counselor advised me...................................................................
I wanted to live near home.....................................................................................
Not offered aid by first choice................................................................................
Could not afford first choice...................................................................................
This college’s graduates gain admission to top graduate/professional schools....
This college’s graduates get good jobs..................................................................
I was attracted by the religious affiliation/orientation of this college......................
I wanted to go to a school about the size of this college.......................................
Rankings in national magazines............................................................................
I was admitted through an Early Action or Early Decision program......................
A visit to this campus.............................................................................................
This college’s graduates make a difference in the world.......................................
VSN
VSN
3
Very
Impo
rta
Som nt
Impoewhat
rtant
Not
Impo
rtant
`.
`.
`
`
`
Ability to see the world
from someone else’s
perspective................ `````
Tolerance of others
with different beliefs.. `````
Openness to having
my own views
challenged................. `````
Ability to discuss and
negotiate controversial
issues......................... `````
Ability to work
cooperatively with
diverse people........... `````
Use technical science skills (use
of tools, instruments, and/or
techniques)....................................
Generate a research question.........
Determine how to collect
appropriate data............................
Explain the results of a study..........
Use scientific literature to guide
research........................................
Integrate results from multiple
studies...........................................
Ask relevant questions....................
Identify what is known and not
known about a problem.................
Understand scientific concepts.......
See connections between different
areas of science and mathematics..
FON
hat Im
portan
t
Not Im
portan
t
Military grants...................................
Work-study.......................................
Pell Grant.........................................
Need-based grants or scholarships...
Merit-based grants or scholarships...
No
FON
FON
38. How confident are you that you
can: (Mark one in each row)
FON
t
Yes
33. What is the highest academic
degree that you intend to
obtain?
(Mark one in each column)
FON
FON
FON
Very Im
portan
28. Did you receive any of the following forms of
financial aid? (Mark Yes or No for each item)
FON
Ask questions in class................................
Support your opinions with a logical
argument..................................................
Seek solutions to problems and explain
them to others...........................................
Evaluate the quality or reliability of
information you received..........................
Take a risk because you feel you have
more to gain.............................................
Seek alternative solutions to a problem.....
Look up scientific research articles
and resources..........................................
Explore topics on your own, even though
it was not required for a class..................
Accept mistakes as part of the learning
process.....................................................
Analyze multiple sources of information
before coming to a conclusion.................
Take on a challenge that scares you.........
Somew
``````
Y12
Y12
Y12
Y12
FON
FON
FON
FON
FON
Averag
``````
35. How would you rate
yourself in the following
areas:
(Mark one for each item)
FON
FON
Streng
th
hat Str
ong
``````
FON
FON
FON
Somew
``````
Felt overwhelmed by all I
had to do.............................
Felt depressed.......................
Performed volunteer work.....
Asked a teacher for advice
after class............................
Voted in a student election....
Socialized with someone of
another racial/ethnic group...
Been late to class..................
Discussed religion.................
Discussed politics..................
Skipped school/class.............
Publicly communicated my
opinion about a cause (e.g.,
blog, email, petition)............
Helped raise money for a
cause or campaign..............
Fallen asleep in class............
Failed to complete
homework on time...............
Felt anxious...........................
A Majo
r
$15,000+
$14,999
9,999
$10,000-
Family resources (parents,
relatives, spouse, etc.)........
My own resources (savings
from work, work-study,
other income)......................
Aid which need not be repaid
(grants, scholarships,
military funding, etc.)...........
Aid which must be repaid
(loans, etc.).........................
5,999
27. How much of your first year’s educational
expenses (room, board, tuition, and fees) do you
expect to cover from each of the sources listed
below? (Mark one answer for
each possible source)
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Not at
All
````
````
Agnostic......................................
Atheist........................................
Baptist........................................
Buddhist.....................................
Church of Christ.........................
Eastern Orthodox.......................
Episcopalian...............................
Hindu..........................................
Jewish........................................
LDS (Mormon)............................
Lutheran.....................................
Methodist....................................
Muslim........................................
Presbyterian...............................
Quaker........................................
Roman Catholic..........................
Seventh-day Adventist...............
United Church of Christ/
Congregational...........................
Other Christian...........................
Other Religion............................
None...........................................
Highest Plann
at This Colle ed
ge
Parent/Guardian 1...................
Parent/Guardian 2...................
Retired
26. Current employment status:
(Mark one in each row)
Employed
Seasonal
ly
Employed
Unemploy
ed
Parent/Guardian 2 career
37. How often in the past year
did you:
(Mark one for each item)
34. Continued. In the past year,
how often have you: (Mark
one for each item)
ionally
`
Major (not sure I will have enough funds
to complete college)
ionally
HEALTHCARE SUPPORT
36 Dietician/Nutritionist
37 Home Health Worker
38 Medical/Dental Assistant
(e.g., Hygienist, Lab Tech,
Nursing Asst.)
39 Registered Nurse
40 Therapist (e.g., Physical,
Occupational, Speech)
Some (but I probably will have enough
funds)
Occas
GOVERNMENT
32 Military
33 Federal/State/Local
Government Official
34 Protective Services
(e.g., Homeland Security,
Law Enforcement, Firefighter)
35 Postal Worker
`
Highest Plann
ed
61 CLERGY
62 HOMEMAKER/STAY AT
HOME PARENT
63 OTHER
64 UNDECIDED
None (I am confident that I will have
sufficient funds)
32. Current religious preference:
(Mark one in each column)
$6,000-$
SERVICE INDUSTRY
55 Custodian/Janitor/Housekeeper
56 Food Service (e.g., Chef/Cook,
Server)
57 Hair Stylist/Aesthetician/
Manicurist
58 Interior Designer
59 Skilled Trades (e.g., Plumber,
Electrician, Construction)
60 Social/Non-Profit Services
`
ntly
EDUCATION
22 College Administrator/Staff
23 College Faculty
24 Early Childcare Provider
25 Elementary School Teacher
26 Secondary School Teacher in
Science, Technology,
Engineering, or Math (STEM)
27 Secondary School Teacher in a
non-STEM subject
28 Librarian
29 Teacher’s Assistant/
Paraprofessional
30 K-12 Administrator
31 Other K-12 Professional
SCIENCE AND ENGINEERING
52 Engineer
53 Research Scientist (e.g., Biologist,
Chemist, Physicist)
54 Urban Planner/Architect
Parent/Guardian 1 career
$3,000-$
COMMUNICATIONS
19 Journalist
20 Public Relations/Media
Relations
21 Advertising
MEDICAL PRACTITIONERS
46 Clinical Psychologist
47 Dentist/Orthodontist
48 Medical Doctor/Surgeon
49 Optometrist
50 Pharmacist
51 Veterinarian
Your intended career
9
BUSINESS
08 Accountant
09 Administrative Assistant
10 Business Manager/Executive
11 Business Owner/Entrepreneur
12 Retail Sales
13 Sales/Marketing
14 Human Resources
15 Finance (e.g., Actuary,
Banking, Loan Officer, Planner)
16 Management Consultant
17 Real Estate Agent/Realtor/
Appraiser/Developer
18 Sports Management
LAW
44 Lawyer/Judge
45 Paralegal
$1-$2,99
AGRICULTURE
06 Farmer or Forester
07 Natural Resource
Specialist/Environmentalist
INFORMATION TECHNOLOGY
41 Computer Programmer/Developer
42 Computer/Systems Analyst
43 Web Designer
None
ARTS
01 Actor or Entertainer
02 Artist
03 Graphic Designer
04 Musician
05 Writer/Producer/Director
31.Do you have any concern about your
ability to finance your college education?
(Mark one)
Freque
25. Please indicate your intended career
as well as the careers of your parents/
guardians, using the codes provided
on the attached fold out. (Your intended
career, Parent/Guardian 1 career, Parent/
Guardian 2 career)
25. Below is a list of different careers grouped into general
categories. (Fill in appropriate two-digit codes on your survey)
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
Carefully detach this section after
answering Questions 24 and 25
`
`
`
`
`
29. What is your best estimate of your parents’/
guardians’ total income last year? Consider
income from all sources before taxes. (Mark one)
`
`
`
`
`
`
Less than $15,000
$15,000-24,999
$25,000-29,999
$30,000-59,999
$60,000-74,999
$75,000-99,999
`
`
`
`
`
`
$100,000-124,999
$125,000-149,999
$150,000-199,999
$200,000-249,999
$250,000-499,999
$500,000 or higher
30. Please select how many individuals in your
household (including yourself) are dependent on
your parent(s)/guardian(s) for financial support.
(Mark one)
`
I am not dependent on
my parent(s)/guardian(s)
`
`
1
2
`
`
`
`
3
4
5
6 or more
34. In the past year, how often
have you: (Mark one for each
item)
Attended a religious service.......
Been bored in class....................
Demonstrated for a cause (e.g.,
boycott, rally, protest)..............
Tutored another student.............
Studied with other students........
Consumed beer..........................
Consumed wine or liquor...........
2
...
...
`
`
FON
FON
FON
FON
FON
FON
FON
Critical thinking skills...
Ability to manage your
time effectively..........
s
`````
`````
36. What is the highest level of formal
education obtained by your parents/
guardians? (Mark one in each column)
Parent/
Guardian 1
Junior high/Middle
school or less...............
Some high school...........
High school graduate.....
Postsecondary school
other than college........
Some college..................
College degree...............
Some graduate school...
Graduate degree............
Parent/
Guardian 2
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
FON
FON
FON
Not at
All
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
39. How would you characterize your political
views? (Mark one)
`
`
`
Far left
Liberal
Middle-of-the-road
`
`
Conservative
Far right
40. In deciding to go to college, how
important to you was each of the
following reasons? (Mark one
answer for each possible reason)
To be able to get a better job.....................
To gain a general education and
appreciation of ideas................................
To make me a more cultured person.........
To be able to make more money...............
To learn more about things that interest
me............................................................
To get training for a specific career...........
To prepare myself for graduate or
professional school..................................
To please my family...................................
VSN
VSN
VSN
VSN
VSN
VSN
Averag
e
Averag
e
Below
Averag
e
Lowes
t 10%
t 10%
Above
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
1 Strongly Disagree
2 Disagree Somewhat
hat
Modera
tely
FON
FON
Highes
Not at
All
ntly
ionally
Oc c a s
Freque
FON
FON
Somew
tely
Very
Absolu
Not at
All
ntly
`
`
`
`
`
`
`
`
Oc c a s
Freque
...
...
...
...
...
.
...
.
...
...
e
Somew
hat We
ak
A Majo
r Weak
nes
Parent/
Guardia
Parent/ n 1
Guardia
n2
Yours
None........................................... `
Vocational certificate.................. `
Associate (A.A. or equivalent).... `
Bachelor’s (B.A., B.S., B.D., etc.).. `
Master’s (M.A., M.S., M.B.A., etc.).. `
J.D. (Law)................................... `
M.D., D.D.S., D.V.M., etc. (Medical).. `
Ph.D........................................... `
Professional Doctorate (Ed.D.,
Psy.D., etc.).............................. `
Other.......................................... `
FON
41. Rate yourself on each of the following
traits as compared with the average
person your age. We want the most
accurate estimate of how you see
yourself. (Mark one in each row)
Academic ability.......................................
Artistic ability............................................
Compassion.............................................
Creativity..................................................
Drive to achieve.......................................
Emotional health.......................................
Leadership ability.....................................
Mathematical ability..................................
Physical health.........................................
Public speaking ability..............................
Risk-taking................................................
Self-confidence (intellectual).....................
Self-confidence (social)............................
Spirituality.................................................
Understanding of others...........................
Writing ability............................................
42. Mark one in each row:
3 Agree Somewhat
4 Strongly Agree
Wealthy people should pay a larger share of taxes than they do now...............
Addressing global climate change should be a federal priority..........................
The federal government should have stricter gun control laws..........................
Affirmative action in college admissions should be abolished............................
The federal government should raise taxes to reduce the deficit.......................
Sexual activity that occurs without the presence of explicit, affirmative
consent (i.e., “yes means yes”) is considered sexual assault..........................
There is little that a person can do to be better at math – you are either
“good” or “bad” at math.....................................................................................
Intelligence is something that can be improved by studying or working harder..
4321
4321
4321
4321
4321
4321
4321
4321
43. Below are some reasons that might have influenced your decision to
attend this particular college. How important was each reason in your
decision to come here? (Mark one answer for each possible reason)
My parents/relatives wanted me to come here......................................................
My teacher advised me..........................................................................................
This college has a very good academic reputation................................................
This college has a good reputation for its social and extracurricular activities......
I was offered financial assistance..........................................................................
The cost of attending this college..........................................................................
High school counselor advised me........................................................................
Private college counselor advised me...................................................................
I wanted to live near home.....................................................................................
Not offered aid by first choice................................................................................
Could not afford first choice...................................................................................
This college’s graduates gain admission to top graduate/professional schools....
This college’s graduates get good jobs..................................................................
I was attracted by the religious affiliation/orientation of this college......................
I wanted to go to a school about the size of this college.......................................
Rankings in national magazines............................................................................
I was admitted through an Early Action or Early Decision program......................
A visit to this campus.............................................................................................
This college’s graduates make a difference in the world.......................................
VSN
VSN
3
Very
Impo
rta
Som nt
Impoewhat
rtant
Not
Impo
rtant
`.
`.
`
`
`
Ability to see the world
from someone else’s
perspective................ `````
Tolerance of others
with different beliefs.. `````
Openness to having
my own views
challenged................. `````
Ability to discuss and
negotiate controversial
issues......................... `````
Ability to work
cooperatively with
diverse people........... `````
Use technical science skills (use
of tools, instruments, and/or
techniques)....................................
Generate a research question.........
Determine how to collect
appropriate data............................
Explain the results of a study..........
Use scientific literature to guide
research........................................
Integrate results from multiple
studies...........................................
Ask relevant questions....................
Identify what is known and not
known about a problem.................
Understand scientific concepts.......
See connections between different
areas of science and mathematics..
FON
hat Im
portan
t
Not Im
portan
t
Military grants...................................
Work-study.......................................
Pell Grant.........................................
Need-based grants or scholarships...
Merit-based grants or scholarships...
No
FON
FON
38. How confident are you that you
can: (Mark one in each row)
FON
t
Yes
33. What is the highest academic
degree that you intend to
obtain?
(Mark one in each column)
FON
FON
FON
Very Im
portan
28. Did you receive any of the following forms of
financial aid? (Mark Yes or No for each item)
FON
Ask questions in class................................
Support your opinions with a logical
argument..................................................
Seek solutions to problems and explain
them to others...........................................
Evaluate the quality or reliability of
information you received..........................
Take a risk because you feel you have
more to gain.............................................
Seek alternative solutions to a problem.....
Look up scientific research articles
and resources..........................................
Explore topics on your own, even though
it was not required for a class..................
Accept mistakes as part of the learning
process.....................................................
Analyze multiple sources of information
before coming to a conclusion.................
Take on a challenge that scares you.........
Somew
``````
Y12
Y12
Y12
Y12
FON
FON
FON
FON
FON
Averag
``````
35. How would you rate
yourself in the following
areas:
(Mark one for each item)
FON
FON
Streng
th
hat Str
ong
``````
FON
FON
FON
Somew
``````
Felt overwhelmed by all I
had to do.............................
Felt depressed.......................
Performed volunteer work.....
Asked a teacher for advice
after class............................
Voted in a student election....
Socialized with someone of
another racial/ethnic group...
Been late to class..................
Discussed religion.................
Discussed politics..................
Skipped school/class.............
Publicly communicated my
opinion about a cause (e.g.,
blog, email, petition)............
Helped raise money for a
cause or campaign..............
Fallen asleep in class............
Failed to complete
homework on time...............
Felt anxious...........................
A Majo
r
$15,000+
$14,999
9,999
$10,000-
Family resources (parents,
relatives, spouse, etc.)........
My own resources (savings
from work, work-study,
other income)......................
Aid which need not be repaid
(grants, scholarships,
military funding, etc.)...........
Aid which must be repaid
(loans, etc.).........................
5,999
27. How much of your first year’s educational
expenses (room, board, tuition, and fees) do you
expect to cover from each of the sources listed
below? (Mark one answer for
each possible source)
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Not at
All
````
````
Agnostic......................................
Atheist........................................
Baptist........................................
Buddhist.....................................
Church of Christ.........................
Eastern Orthodox.......................
Episcopalian...............................
Hindu..........................................
Jewish........................................
LDS (Mormon)............................
Lutheran.....................................
Methodist....................................
Muslim........................................
Presbyterian...............................
Quaker........................................
Roman Catholic..........................
Seventh-day Adventist...............
United Church of Christ/
Congregational...........................
Other Christian...........................
Other Religion............................
None...........................................
Highest Plann
at This Colle ed
ge
Parent/Guardian 1...................
Parent/Guardian 2...................
Retired
26. Current employment status:
(Mark one in each row)
Employed
Seasonal
ly
Employed
Unemploy
ed
Parent/Guardian 2 career
37. How often in the past year
did you:
(Mark one for each item)
34. Continued. In the past year,
how often have you: (Mark
one for each item)
ionally
`
Major (not sure I will have enough funds
to complete college)
ionally
HEALTHCARE SUPPORT
36 Dietician/Nutritionist
37 Home Health Worker
38 Medical/Dental Assistant
(e.g., Hygienist, Lab Tech,
Nursing Asst.)
39 Registered Nurse
40 Therapist (e.g., Physical,
Occupational, Speech)
Some (but I probably will have enough
funds)
Occas
GOVERNMENT
32 Military
33 Federal/State/Local
Government Official
34 Protective Services
(e.g., Homeland Security,
Law Enforcement, Firefighter)
35 Postal Worker
`
Highest Plann
ed
61 CLERGY
62 HOMEMAKER/STAY AT
HOME PARENT
63 OTHER
64 UNDECIDED
None (I am confident that I will have
sufficient funds)
32. Current religious preference:
(Mark one in each column)
$6,000-$
SERVICE INDUSTRY
55 Custodian/Janitor/Housekeeper
56 Food Service (e.g., Chef/Cook,
Server)
57 Hair Stylist/Aesthetician/
Manicurist
58 Interior Designer
59 Skilled Trades (e.g., Plumber,
Electrician, Construction)
60 Social/Non-Profit Services
`
ntly
EDUCATION
22 College Administrator/Staff
23 College Faculty
24 Early Childcare Provider
25 Elementary School Teacher
26 Secondary School Teacher in
Science, Technology,
Engineering, or Math (STEM)
27 Secondary School Teacher in a
non-STEM subject
28 Librarian
29 Teacher’s Assistant/
Paraprofessional
30 K-12 Administrator
31 Other K-12 Professional
SCIENCE AND ENGINEERING
52 Engineer
53 Research Scientist (e.g., Biologist,
Chemist, Physicist)
54 Urban Planner/Architect
Parent/Guardian 1 career
$3,000-$
COMMUNICATIONS
19 Journalist
20 Public Relations/Media
Relations
21 Advertising
MEDICAL PRACTITIONERS
46 Clinical Psychologist
47 Dentist/Orthodontist
48 Medical Doctor/Surgeon
49 Optometrist
50 Pharmacist
51 Veterinarian
Your intended career
9
BUSINESS
08 Accountant
09 Administrative Assistant
10 Business Manager/Executive
11 Business Owner/Entrepreneur
12 Retail Sales
13 Sales/Marketing
14 Human Resources
15 Finance (e.g., Actuary,
Banking, Loan Officer, Planner)
16 Management Consultant
17 Real Estate Agent/Realtor/
Appraiser/Developer
18 Sports Management
LAW
44 Lawyer/Judge
45 Paralegal
$1-$2,99
AGRICULTURE
06 Farmer or Forester
07 Natural Resource
Specialist/Environmentalist
INFORMATION TECHNOLOGY
41 Computer Programmer/Developer
42 Computer/Systems Analyst
43 Web Designer
None
ARTS
01 Actor or Entertainer
02 Artist
03 Graphic Designer
04 Musician
05 Writer/Producer/Director
31.Do you have any concern about your
ability to finance your college education?
(Mark one)
Freque
25. Please indicate your intended career
as well as the careers of your parents/
guardians, using the codes provided
on the attached fold out. (Your intended
career, Parent/Guardian 1 career, Parent/
Guardian 2 career)
25. Below is a list of different careers grouped into general
categories. (Fill in appropriate two-digit codes on your survey)
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
`
`
Yes
No
53. What is your best guess as to
the chances that you will:
(Mark one for each item)
49. Do you have any of the following disabilities or
medical conditions? (Mark Yes or No for each item)
Yes
Learning disability (dyslexia, etc.).........................
Attention deficit hyperactivity disorder (ADHD).....
Autism spectrum disorder.....................................
Physical disability (speech, sight, mobility,
hearing, etc.).......................................................
Chronic illness (cancer, diabetes, autoimmune
disorders, etc.)....................................................
Psychological disorder (depression, etc.).............
Other.....................................................................
No
` `
` `
` `
` `
` `
` `
` `
50. Will you pursue a science-related research career?
(Mark one)
`
`
`
`
`
Definitely yes
Probably yes
Uncertain
Probably no
Definitely no
N No Chance
L Very Little Chance
S Some Chance
V Very Good Chance
Change major field......................................................................
Change career choice.................................................................
Participate in student government...............................................
Get a job to help pay for college expenses................................
Join a social fraternity or sorority................................................
Transfer to another college before graduating............................
Participate in volunteer or community service work....................
Seek personal counseling...........................................................
Communicate regularly with your professors..............................
Participate in student clubs/groups.............................................
Participate in a study abroad program........................................
Work on a professor’s research project......................................
Get tutoring help in specific courses...........................................
Take courses from more than one college simultaneously.........
Take a leave of absence from this college temporarily..............
Take a course exclusively online................................................
Vote in a local, state, or national election...................................
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
The remaining ovals are provided for questions specifically designed by your college rather than the Higher Education Research
Institute. If your college has chosen to use the ovals, please observe carefully the supplemental directions given to you.
54.
55.
56.
57.
ABCDE
ABCDE
ABCDE
ABCDE
58.
59.
60.
61.
62.
63.
64.
65.
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
ABCDE
66.
67.
68.
69.
ABCDE
ABCDE
ABCDE
ABCDE
70.
71.
72.
73.
ABCDE
ABCDE
ABCDE
ABCDE
THANK YOU!
© Prepared by the Higher Education Research Institute,
University of California, Los Angeles, California 90095-1521
4
Data Recognition Corp.-6G6144-15767-54321
9. From what high school did you graduate? 17. Please mark which of the following courses you
have completed:
Name of high school
YN Algebra II
YN Pre-calculus/Trigonometry
YN Probability & Statistics
City
State
YN Calculus
CORRECT MARK INCORRECT MARKS
YN AP Probability & Statistics
a~aa
aaaa
YN AP Calculus
10. Are you: (Mark all that apply)
A
B
YN AP Computer Science A
` White/Caucasian
Group Code
How many weeks this summer did you participate
18.
` African American/Black
in a bridge program at this institution?
` American Indian/Alaska Native
Your sex: ` Male
` Female
` 7+
` 0
` 3-4
` East Asian (e.g., Chinese, Japanese,
1-2
5-6
Korean, Taiwanese)
`
`
Is English your primary language?
Filipino
`
During
high
school
(grades 9-12) how many years
19.
Yes
No
`
`
Southeast Asian (e.g., Cambodian,
did you study each of the following subjects?
`
In what year did you graduate from
Vietnamese, Hmong)
(Mark one for each item)
high school? (Mark one)
South
Asian (e.g., Indian, Pakistani,
`
Nepalese, Sri Lankan)
` Did not graduate but
` 2016
Mathematics.................... ```````
passed G.E.D. test
2015
`
` Other Asian
Foreign Language........... ```````
` Never completed
` 2014
` Native Hawaiian/Pacific Islander
Physical Science............. ```````
high
school
` 2013 or earlier
` Mexican American/Chicano
Biological Science........... ```````
Are you enrolled (or enrolling) as a:
` Puerto Rican
History/Am. Gov’t............ ```````
(Mark one)
` Other Latino
` Full-time student
Computer Science........... ```````
` Other
` Part-time student
Arts and/or Music............ ```````
11. Prior to this term, have you ever taken
How many miles is this college from
20.
How many Advanced Placement/International
courses for credit at this institution?
your permanent home? (Mark one)
Baccalaureate courses did you take in high school?
` Yes
` No
(Mark one in each row)
` 5 or less ` 11-50 ` 101-500
3.
4.
5.
4
2.
5o
morre
1.
MARKING DIRECTIONS
• Use a black or blue pen.
• Fill in your response completely.
Mark out any answer you wish to
change with an “X”.
Over 500 12. Since leaving high school, have you ever
taken courses, whether for credit or not
6. What was your average grade in high
for credit, at any other institution
school? (Mark one)
(university, 4- or 2-year college, technical,
vocational, or business school)?
` C
` A or A+ ` B
AP Courses........................... ``````
` D
` A–
` B–
` Yes
` No
IB Courses............................. ``````
13. To how many colleges other than this one
` B+
` C+
21.
Please refer to the same Parent/Guardian
did you apply for admission this year?
7. What were your scores on the SAT I
throughout this survey. Please mark the sex of
` 11 or
` None ` 3 ` 6
and/or ACT?
your parent(s) or guardian(s).
more
Male Female
4 ` 7-8
1
`
`
SAT Reading and Writing....
5
9-10
2
Parent/Guardian
1............................
` `
`. `
`
Parent/Guardian 2............................ ` . `
14. Were you accepted by your first choice
SAT Mathematics................
college? ` Yes
` No
22. At any time since you turned 13, were you in foster
care or were you a dependent of the court?
15.
Is
this
college
your:
(Mark
one)
ACT Composite........................
` Yes ` No
` I don’t know
` First choice
` Third choice
8. Where do you plan to live during the fall
you consider yourself: (Mark Yes or No for
` Second choice ` Less than third choice 23. Do
term? (Mark one)
each item)
Yes
No
16. Citizenship status: (Mark one)
` With my family or other relatives
Pre-Med............................................ ` . `
Other
private
home,
apartment,
or
room
U.S.
citizen
`
`
Pre-Law............................................ ` . `
College residence hall
Permanent resident (green card)
`
`
`
`
`
6-10
`
51-100
`
Fraternity or sorority house
Other campus student housing
Other
`
`
`
International student (i.e., F-1, J-1, or
M-1 visa)
None of the above
15+
48. Do you identify as transgender?
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EMAIL (print letters carefully):
3
Bisexual
Queer
Other
EVSN
EVSN
COUNTRY,
if NOT USA:
10-14
`
`
`
STUDENT ID# (as instructed):
ZIP:
2
Heterosexual/Straight
Gay
Lesbian
Becoming accomplished in one of the performing arts
(acting, dancing, etc.)...............................................................
Becoming an authority in my field..............................................
Obtaining recognition from my colleagues for contributions
to my special field....................................................................
Influencing the political structure................................................
Influencing social values............................................................
Raising a family..........................................................................
Being very well off financially.....................................................
Helping others who are in difficulty............................................
Making a theoretical contribution to science..............................
Writing original works (poems, novels, etc.)..............................
Creating artistic works (painting, sculpture, etc.).......................
Becoming successful in a business of my own..........................
Becoming involved in programs to clean up the environment...
Developing a meaningful philosophy of life................................
Participating in a community action program.............................
Helping to promote racial understanding...................................
Keeping up to date with political affairs.....................................
Becoming a community leader...................................................
Improving my understanding of other countries and cultures....
Integrating spirituality into my life...............................................
STATE:
5-9
6+
47. What is your sexual orientation?
`
`
`
CITY:
Year
Day
(01-31)
1
` 2 ` 3 ` 4 ` 5 `
` I do not plan to graduate from this college.
N Not Important
S Somewhat Important
Month
(01-12)
ADDRESS:
1-4
None
ROTC, cadet, or midshipman at a service academy
In the Reserves or National Guard
On Active Duty
A discharged veteran NOT serving on Active Duty,
in Reserves, or in National Guard
1
54321
54321
54321
NAME:
V Very Important
E Essential
46. How many years do you expect it will take you to
graduate from this college?
`
54321
When were you born?
1/2
52. Please indicate the importance to you
personally of each of the following:
(Mark one for each item)
45. Military Status: (Mark one)
`
`
`
`
`
I have a strong sense of belonging to a community
of scientists..............................................................
I derive great personal satisfaction from working
on a team that is doing important research.............
I think of myself as a scientist....................................
I feel like I belong in the field of science....................
PLEASE PRINT IN ALL CAPS YOUR NAME AND PERMANENT/HOME ADDRESS (one letter or number per box).
FIRST
MI
LAST
None
````````
````````
````````
````````
````````
````````
4 Agree Somewhat
5 Strongly Agree
24. Below is a list of different undergraduate major fields grouped
into general categories. (Fill in appropriate two-digit code on
your survey)
Not o
my h ffered at
igh s
choo
None
l
Over
20
16-20
11-15
6-10
3-5
````````
````````
2016 CIRP Freshman Survey
51. To what extent are the following
1 Strongly Disagree
statements true of you:
2 Disagree Somewhat
(Mark one in each row)
3 Neutral
SERIAL #
Studying/homework....................
Socializing with friends in person..
Online social networks
(Facebook, Twitter, etc.)...........
Partying......................................
Student clubs/groups..................
Exercise or sports......................
Working (for pay)........................
Household/childcare duties........
1-2
Hours per week:
Less
None
than
1 hou
r
44. During your last year in high school, how much time
did you spend during a typical week doing the
following activities?
ARTS AND HUMANITIES
01 Art, fine and applied
02 English (language and literature)
03 History
04 Journalism/Communication
05 Classical and Modern
Languages and Literature
06 Media/Film Studies
07 Music
08 Philosophy
09 Theatre/Drama
10 Theology/ Religion
11 Other Arts and Humanities
BIOLOGICAL & LIFE
SCIENCES
12 Biology (general)
13 Animal Biology (zoology)
14 Ecology & Evolutionary
Biology
15 Marine Biology
16 Microbiology
17 Molecular, Cellular, &
Developmental Biology
18 Neurobiology/Neuroscience
19 Plant Biology (botany)
20 Agriculture/Natural Resources
21 Biochemistry/Biophysics
22 Environmental Science
23 Other Biological Science
BUSINESS
24 Accounting
25 Business Admin. (general)
26 Entrepreneurship
27 Finance
28 Hospitality/Tourism
29 Human Resources Management
30 International Business
31 Marketing
32 Management
33 Computer/Management
Information Systems
34 Real Estate
35 Other Business
EDUCATION
36 Elementary Education
37 Music/Art Education
38 Physical Education/Recreation
39 Secondary Education
40 Special Education
41 Other Education
HEALTH PROFESSIONS
55 Clinical Laboratory Science
56 Health Care Administration/
Studies
57 Health Technology
58 Kinesiology
59 Nursing
60 Pharmacy
61 Therapy (occupational,
physical, speech)
62 Other Health Profession
MATH AND COMPUTER
SCIENCE
63 Computer Science
64 Mathematics/Statistics
65 Other Math and Computer
Science
PHYSICAL SCIENCE
66 Astronomy & Astrophysics
67 Atmospheric Sciences
68 Chemistry
69 Earth & Planetary Sciences
70 Marine Sciences
71 Physics
72 Other Physical Science
SOCIAL SCIENCE
73 Anthropology
74 Economics
75 Ethnic/Cultural Studies
76 Geography
77 Political Science (gov’t.,
international relations)
78 Psychology
79 Public Policy
80 Social Work
81 Sociology
82 Women’s/Gender Studies
83 Other Social Science
OTHER MAJORS
84 Architecture/Urban Planning
85 Criminal Justice
86 Library Science
87 Security & Protective
Services
88 Military Sciences/
Technology/Operations
89 OTHER
90 UNDECIDED
ENGINEERING
42 Aerospace/Aeronautical/
Astronautical Engineering
43 Biological/Agricultural
Engineering
44 Biomedical Engineering
45 Chemical Engineering
46 Civil Engineering
47 Computer Engineering
48 Electrical/ Electronic/
Communications Engineering
49 Engineering Science/
Engineering Physics
50 Environmental/Environmental
Health Engineering
51 Industrial/Manufacturing
Engineering
52 Materials Engineering
53 Mechanical Engineering
54 Other Engineering
24. Please indicate your intended major using the
codes provided on the
attached fold out.
Turn over for Question 25
1
Bisexual
Queer
Other
48. Do you identify as transgender?
`
`
Yes
No
53. What is your best guess as to
the chances that you will:
(Mark one for each item)
49. Do you have any of the following disabilities or
medical conditions? (Mark Yes or No for each item)
Yes
Learning disability (dyslexia, etc.).........................
Attention deficit hyperactivity disorder (ADHD).....
Autism spectrum/Asperger’s syndrome................
Physical disability (speech, sight, mobility,
hearing, etc.).......................................................
Chronic illness (cancer, diabetes, autoimmune
disorders, etc.)....................................................
Psychological disorder (depression, etc.).............
Other.....................................................................
No
` `
` `
` `
` `
` `
` `
` `
50. Will you pursue a science-related research career?
(Mark one)
`
`
`
`
`
Definitely yes
Probably yes
Uncertain
Probably no
Definitely no
N No Chance
L Very Little Chance
S Some Chance
V Very Good Chance
Change major field......................................................................
Change career choice.................................................................
Participate in student government...............................................
Get a job to help pay for college expenses................................
Join a social fraternity or sorority................................................
Transfer to another college before graduating............................
Participate in volunteer or community service work....................
Seek personal counseling...........................................................
Communicate regularly with your professors..............................
Participate in student clubs/groups.............................................
Participate in a study abroad program........................................
Work on a professor’s research project......................................
Get tutoring help in specific courses...........................................
Take courses from more than one college simultaneously.........
Take a leave of absence from this college temporarily..............
Take a course exclusively online................................................
Vote in a local, state, or national election...................................
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
VSLN
The remaining ovals are provided for questions specifically designed by your college rather than the Higher Education Research
Institute. If your college has chosen to use the ovals, please observe carefully the supplemental directions given to you.
54.
55.
56.
57.
ABCDE
ABCDE
ABCDE
ABCDE
58.
59.
60.
61.
ABCDE
ABCDE
ABCDE
ABCDE
62.
63.
64.
65.
ABCDE
ABCDE
ABCDE
ABCDE
66.
67.
68.
69.
ABCDE
ABCDE
ABCDE
ABCDE
70.
71.
72.
73.
ABCDE
ABCDE
ABCDE
ABCDE
THANK YOU!
© Prepared by the Higher Education Research Institute, University
of California, Los Angeles, California 90095-1521
4
Data Recognition Corp.-6G6144-15767-54321
4.
5.
6.
7.
SAT Mathematics................
14. Were you accepted by your first choice
college? ` Yes
` No
ACT Composite........................
15. Is this college your: (Mark one)
8. Where do you plan to live during the fall
term? (Mark one)
`
`
`
`
`
`
With my family or other relatives
Other private home, apartment, or room
College residence hall
Fraternity or sorority house
Other campus student housing
Other
`
`
First choice
Second choice
`
`
Third choice
Less than third choice
16. Citizenship status: (Mark one)
`
`
`
`
U.S. citizen
Permanent resident (green card)
International student (i.e., F-1, J-1, or
M-1 visa)
None of the above
1
4
3.
5o
morre
2.
3
1.
2
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
EVSN
9. From what high school did you graduate? 17. Please mark which of the following courses you
have completed:
Name of high school
YN Algebra II
YN Pre-calculus/Trigonometry
YN Probability & Statistics
City
State
YN Calculus
CORRECT MARK INCORRECT MARKS
YN AP Probability & Statistics
a~aa
aaaa
YN AP Calculus
10. Are you: (Mark all that apply)
A
B
How many weeks this summer did you participate
18.
` White/Caucasian
in a bridge program at this institution?
Group Code
` African American/Black
` 7+
` 0
` 3-4
` American Indian/Alaska Native
Your sex: ` Male
1-2
5-6
` Female
`
`
` East Asian (e.g., Chinese, Japanese,
Korean, Taiwanese)
19. During high school (grades 9-12) how many years
Is English your primary language?
did you study each of the following subjects?
` Filipino
` Yes
` No
(Mark one for each item)
Southeast
Asian
(e.g.,
Cambodian,
`
In what year did you graduate from
Vietnamese, Hmong)
high school? (Mark one)
Mathematics.................... ```````
` South Asian (e.g., Indian, Pakistani,
Nepalese, Sri Lankan)
` Did not graduate but
` 2016
Foreign Language........... ```````
passed
G.E.D.
test
` 2015
` Other Asian
Physical Science............. ```````
` Never completed
` 2014
` Native Hawaiian/Pacific Islander
Biological Science........... ```````
high
school
` 2013 or earlier
` Mexican American/Chicano
History/Am. Gov’t............ ```````
Are you enrolled (or enrolling) as a:
` Puerto Rican
Computer Science........... ```````
(Mark one)
` Other Latino
` Full-time student
Arts and/or Music............ ```````
` Other
` Part-time student
20. How many Advanced Placement/International
11. Prior to this term, have you ever taken
Baccalaureate courses did you take in high school?
How many miles is this college from
courses for credit at this institution?
(Mark one in each row)
your permanent home? (Mark one)
` Yes
` No
` 5 or less ` 11-50 ` 101-500
` 6-10
` 51-100 ` Over 500 12. Since leaving high school, have you ever
taken courses, whether for credit or not
What was your average grade in high
for credit, at any other institution
school? (Mark one)
(university, 4- or 2-year college, technical,
AP Courses........................... ``````
vocational, or business school)?
` C
` A or A+ ` B
IB Courses............................. ``````
` D
` A–
` B–
` Yes
` No
21. Please refer to the same Parent/Guardian
13. To how many colleges other than this one
` B+
` C+
throughout this survey. Please mark the sex of
did you apply for admission this year?
your parent(s) or guardian(s).
What were your scores on the SAT I
Male Female
` 11 or
` None ` 3 ` 6
and/or ACT?
more
4
7-8
1
Parent/Guardian
1............................
` `
`. `
`
SAT Reading and Writing....
5
9-10
2
Parent/Guardian
2............................
` `
`. `
`
MARKING DIRECTIONS
• Use a black or blue pen.
• Fill in your response completely.
Mark out any answer you wish to
change with an “X”.
15+
`
`
`
EVSN
EVSN
ZIP:
EMAIL (print letters carefully):
10-14
Heterosexual/Straight
Gay
Lesbian
Becoming accomplished in one of the performing arts
(acting, dancing, etc.)...............................................................
Becoming an authority in my field..............................................
Obtaining recognition from my colleagues for contributions
to my special field....................................................................
Influencing the political structure................................................
Influencing social values............................................................
Raising a family..........................................................................
Being very well off financially.....................................................
Helping others who are in difficulty............................................
Making a theoretical contribution to science..............................
Writing original works (poems, novels, etc.)..............................
Creating artistic works (painting, sculpture, etc.).......................
Becoming successful in a business of my own..........................
Becoming involved in programs to clean up the environment...
Developing a meaningful philosophy of life................................
Participating in a community action program.............................
Helping to promote racial understanding...................................
Keeping up to date with political affairs.....................................
Becoming a community leader...................................................
Improving my understanding of other countries and cultures....
Integrating spirituality into my life...............................................
STATE:
STUDENT ID# (as instructed):
5-9
6+
47. What is your sexual orientation?
`
`
`
CITY:
Year
Day
(01-31)
1
` 2 ` 3 ` 4 ` 5 `
` Do not plan to graduate from this college
N Not Important
S Somewhat Important
Month
(01-12)
ADDRESS:
1-4
None
ROTC, cadet, or midshipman at a service academy
In the Reserves or National Guard
On Active Duty
A discharged veteran NOT serving on Active Duty,
in Reserves, or in National Guard
1
54321
54321
54321
NAME:
V Very Important
E Essential
46. How many years do you expect it will take you to
graduate from this college?
`
54321
When were you born?
1/2
52. Please indicate the importance to you
personally of each of the following:
(Mark one for each item)
45. Military Status: (Mark one)
`
`
`
`
`
I have a strong sense of belonging to a community
of scientists..............................................................
I derive great personal satisfaction from working
on a team that is doing important research.............
I think of myself as a scientist....................................
I feel like I belong in the field of science....................
PLEASE PRINT IN ALL CAPS YOUR NAME AND PERMANENT/HOME ADDRESS (one letter or number per box).
FIRST
MI
LAST
None
````````
````````
````````
````````
````````
````````
4 Agree Somewhat
5 Agree Strongly
24. Below is a list of different undergraduate major fields grouped
into general categories. (Fill in appropriate two-digit code on
your survey)
Not o
my h ffered at
igh s
choo
None
l
Over
20
16-20
11-15
6-10
3-5
````````
````````
2016 CIRP Freshman Survey
51. To what extent are the following
1 Disagree Strongly
statements true of you:
2 Disagree Somewhat
(Mark one in each row)
3 Neutral
SERIAL #
Studying/homework....................
Socializing with friends in person..
Online social networks
(Facebook, Twitter, etc.)...........
Partying......................................
Student clubs/groups..................
Exercise or sports......................
Working (for pay)........................
Household/childcare duties........
1-2
Hours per week:
Less
None
than
1 hou
r
44. During your last year in high school, how much time
did you spend during a typical week doing the
following activities?
22. At any time since you turned 13, were you in foster
care or were you a dependent of the court?
`
`
`
Yes
No
I don’t know
23. Do you consider yourself: (Mark Yes or No for
each item)
Yes
Pre-Med............................................
Pre-Law............................................
No
`. `
`. `
24. Please indicate your intended major using the
codes provided on the
attached fold out.
ARTS AND HUMANITIES
01 Art, fine and applied
02 English (language and literature)
03 History
04 Journalism/Communication
05 Classical and Modern
Languages and Literature
06 Media/Film Studies
07 Music
08 Philosophy
09 Theatre/Drama
10 Theology/ Religion
11 Other Arts and Humanities
BIOLOGICAL & LIFE
SCIENCES
12 Biology (general)
13 Animal Biology (zoology)
14 Ecology & Evolutionary
Biology
15 Marine Biology
16 Microbiology
17 Molecular, Cellular, &
Developmental Biology
18 Neurobiology/Neuroscience
19 Plant Biology (botany)
20 Agriculture/Natural Resources
21 Biochemistry/Biophysics
22 Environmental Science
23 Other Biological Science
BUSINESS
24 Accounting
25 Business Admin. (general)
26 Entrepreneurship
27 Finance
28 Hospitality/Tourism
29 Human Resources Management
30 International Business
31 Marketing
32 Management
33 Computer/Management
Information Systems
34 Real Estate
35 Other Business
EDUCATION
36 Elementary Education
37 Music/Art Education
38 Physical Education/Recreation
39 Secondary Education
40 Special Education
41 Other Education
HEALTH PROFESSIONS
55 Clinical Laboratory Science
56 Health Care Administration/
Studies
57 Health Technology
58 Kinesiology
59 Nursing
60 Pharmacy
61 Therapy (occupational,
physical, speech)
62 Other Health Profession
MATH AND COMPUTER
SCIENCE
63 Computer Science
64 Mathematics/Statistics
65 Other Math and Computer
Science
PHYSICAL SCIENCE
66 Astronomy & Astrophysics
67 Atmospheric Sciences
68 Chemistry
69 Earth & Planetary Sciences
70 Marine Sciences
71 Physics
72 Other Physical Science
SOCIAL SCIENCE
73 Anthropology
74 Economics
75 Ethnic/Cultural Studies
76 Geography
77 Political Science (gov’t.,
international relations)
78 Psychology
79 Public Policy
80 Social Work
81 Sociology
82 Women’s/Gender Studies
83 Other Social Science
OTHER MAJORS
84 Architecture/Urban Planning
85 Criminal Justice
86 Library Science
87 Security & Protective
Services
88 Military Sciences/
Technology/Operations
89 OTHER
90 UNDECIDED
ENGINEERING
42 Aerospace/Aeronautical/
Astronautical Engineering
43 Biological/Agricultural
Engineering
44 Biomedical Engineering
45 Chemical Engineering
46 Civil Engineering
47 Computer Engineering
48 Electrical/ Electronic/
Communications Engineering
49 Engineering Science/
Engineering Physics
50 Environmental/Environmental
Health Engineering
51 Industrial/Manufacturing
Engineering
52 Materials Engineering
53 Mechanical Engineering
54 Other Engineering
Turn over for Question 25
Carefully detach this section after
answering Questions 24 and 25
`
`
`
`
`
29. What is your best estimate of your parents’/
guardians’ total income last year? Consider
income from all sources before taxes. (Mark one)
`
`
`
`
`
`
Less than $15,000
$15,000-24,999
$25,000-29,999
$30,000-59,999
$60,000-74,999
$75,000-99,999
`
`
`
`
`
`
$100,000-124,999
$125,000-149,999
150,000-199,999
$200,000-249,999
$250,000-499,999
$500,000 or higher
30. Please select how many individuals in your
household (including yourself) are dependent on
your parent(s)/guardian(s) for financial support.
(Mark one)
`
I am not dependent on
my parent(s)/guardian(s)
`
`
1
2
`
`
`
`
3
4
5
6 or more
34. In the past year, how often
have you: (Mark one for each
item)
Attended a religious service.......
Been bored in class....................
Demonstrated for a cause (e.g.,
boycott, rally, protest)..............
Tutored another student.............
Studied with other students........
Consumed beer..........................
Consumed wine or liquor...........
2
...
...
`
`
FON
FON
FON
FON
FON
FON
FON
Critical thinking skills...
Ability to manage your
time effectively..........
s
`````
`````
36. What is the highest level of formal
education obtained by your parents/
guardians? (Mark one in each column)
Parent/
Guardian 1
Junior high/Middle
school or less...............
Some high school...........
High school graduate.....
Postsecondary school
other than college........
Some college..................
College degree...............
Some graduate school...
Graduate degree............
Parent/
Guardian 2
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
` ........... `
FON
FON
FON
Not at
all
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
AVMSN
39. How would you characterize your political
views? (Mark one)
`
`
`
Far left
Liberal
Middle-of-the-road
`
`
Conservative
Far right
40. In deciding to go to college, how
important to you was each of the
following reasons? (Mark one
answer for each possible reason)
To be able to get a better job.....................
To gain a general education and
appreciation of ideas................................
To make me a more cultured person.........
To be able to make more money...............
To learn more about things that interest
me............................................................
To get training for a specific career...........
To prepare myself for graduate or
professional school..................................
To please my family...................................
VSN
VSN
VSN
VSN
VSN
VSN
Averag
e
Averag
e
Below
Averag
e
Lowes
t 10%
t 10%
Above
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
`````
1 Disagree Strongly
2 Disagree Somewhat
hat
Modera
tely
FON
FON
Highes
Not at
All
ntly
ionally
Oc c a s
Freque
FON
FON
Somew
tely
Very
Absolu
Not at
All
ntly
`
`
`
`
`
`
`
`
Oc c a s
Freque
...
...
...
...
...
.
...
.
...
...
e
Somew
hat We
ak
A Majo
r Weak
nes
Parent/
Guardia
Parent/ n 1
Guardia
n2
Yours
None........................................... `
Vocational certificate.................. `
Associate (A.A. or equivalent).... `
Bachelor’s (B.A., B.S., B.D., etc.).. `
Master’s (M.A., M.S., M.B.A., etc.).. `
J.D. (Law)................................... `
M.D., D.D.S., D.V.M., etc. (Medical).. `
Ph.D........................................... `
Professional Doctorate (Ed.D.,
Psy.D., etc.).............................. `
Other.......................................... `
FON
41. Rate yourself on each of the following
traits as compared with the average
person your age. We want the most
accurate estimate of how you see
yourself. (Mark one in each row)
Academic ability.......................................
Artistic ability............................................
Compassion.............................................
Creativity..................................................
Drive to achieve.......................................
Emotional health.......................................
Leadership ability.....................................
Mathematical ability..................................
Physical health.........................................
Public speaking ability..............................
Risk-taking................................................
Self-confidence (intellectual).....................
Self-confidence (social)............................
Spirituality.................................................
Understanding of others...........................
Writing ability............................................
42. Mark one in each row:
3 Agree Somewhat
4 Agree Strongly
Wealthy people should pay a larger share of taxes than they do now...............
Addressing global climate change should be a federal priority..........................
The federal government should have stricter gun control laws..........................
Affirmative action in college admissions should be abolished............................
The federal government should raise taxes to reduce the deficit.......................
Sexual activity that occurs without the presence of explicit, affirmative
consent (i.e., “yes means yes”) is considered sexual assault..........................
There is little that a person can do to be better at math – you are either
“good” or “bad” at math.....................................................................................
Intelligence is something that can be improved by studying or working harder..
4321
4321
4321
4321
4321
4321
4321
4321
43. Below are some reasons that might have influenced your decision to
attend this particular college. How important was each reason in your
decision to come here? (Mark one answer for each possible reason)
My parents/relatives wanted me to come here......................................................
My teacher advised me..........................................................................................
This college has a very good academic reputation................................................
This college has a good reputation for its social and extracurricular activities......
I was offered financial assistance..........................................................................
The cost of attending this college..........................................................................
High school counselor advised me........................................................................
Private college counselor advised me...................................................................
I wanted to live near home.....................................................................................
Not offered aid by first choice................................................................................
Could not afford first choice...................................................................................
This college’s graduates gain admission to top graduate/professional schools....
This college’s graduates get good jobs..................................................................
I was attracted by the religious affiliation/orientation of this college......................
I wanted to go to a school about the size of this college.......................................
Rankings in national magazines............................................................................
I was admitted through an Early Action or Early Decision program......................
A visit to this campus.............................................................................................
This college’s graduates make a difference in the world.......................................
VSN
VSN
3
Very
Impo
rta
Som nt
Impoewhat
rtant
Not
Impo
rtant
`.
`.
`
`
`
Ability to see the world
from someone else’s
perspective................ `````
Tolerance of others
with different beliefs.. `````
Openness to having
my own views
challenged................. `````
Ability to discuss and
negotiate controversial
issues......................... `````
Ability to work
cooperatively with
diverse people........... `````
Use technical science skills (use
of tools, instruments, and/or
techniques)....................................
Generate a research question.........
Determine how to collect
appropriate data............................
Explain the results of a study..........
Use scientific literature to guide
research........................................
Integrate results from multiple
studies...........................................
Ask relevant questions....................
Identify what is known and not
known about a problem.................
Understand scientific concepts.......
See connections between different
areas of science and mathematics..
FON
hat Im
portan
t
Not Im
portan
t
Military grants...................................
Work-study.......................................
Pell Grant.........................................
Need-based grants or scholarships...
Merit-based grants or scholarships...
No
FON
FON
38. How confident are you that you
can: (Mark one in each row)
FON
t
Yes
33. What is the highest academic
degree that you intend to
obtain?
(Mark one in each column)
FON
FON
FON
Very Im
portan
28. Did you receive any of the following forms of
financial aid? (Mark Yes or No for each item)
FON
Ask questions in class................................
Support your opinions with a logical
argument..................................................
Seek solutions to problems and explain
them to others...........................................
Evaluate the quality or reliability of
information you received..........................
Take a risk because you feel you have
more to gain.............................................
Seek alternative solutions to a problem.....
Look up scientific research articles
and resources..........................................
Explore topics on your own, even though
it was not required for a class..................
Accept mistakes as part of the learning
process.....................................................
Analyze multiple sources of information
before coming to a conclusion.................
Take on a challenge that scares you.........
Somew
``````
Y12
Y12
Y12
Y12
FON
FON
FON
FON
FON
Averag
``````
35. How would you rate
yourself in the following
areas:
(Mark one for each item)
FON
FON
Streng
th
hat Str
ong
``````
FON
FON
FON
Somew
``````
Felt overwhelmed by all I
had to do.............................
Felt depressed.......................
Performed volunteer work.....
Asked a teacher for advice
after class............................
Voted in a student election....
Socialized with someone of
another racial/ethnic group...
Been late to class..................
Discussed religion.................
Discussed politics..................
Skipped school/class.............
Publicly communicated my
opinion about a cause (e.g.,
blog, email, petition)............
Helped raise money for a
cause or campaign..............
Fallen asleep in class............
Failed to complete
homework on time...............
Felt anxious...........................
A Majo
r
$15,000+
$14,999
9,999
$10,000-
Family resources (parents,
relatives, spouse, etc.)........
My own resources (savings
from work, work-study,
other income)......................
Aid which need not be repaid
(grants, scholarships,
military funding, etc.)...........
Aid which must be repaid
(loans, etc.).........................
5,999
27. How much of your first year’s educational
expenses (room, board, tuition, and fees) do you
expect to cover from each of the sources listed
below? (Mark one answer for
each possible source)
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Y12
Not at
All
````
````
Agnostic......................................
Atheist........................................
Baptist........................................
Buddhist.....................................
Church of Christ.........................
Eastern Orthodox.......................
Episcopalian...............................
Hindu..........................................
Jewish........................................
LDS (Mormon)............................
Lutheran.....................................
Methodist....................................
Muslim........................................
Presbyterian...............................
Quaker........................................
Roman Catholic..........................
Seventh-day Adventist...............
United Church of Christ/
Congregational...........................
Other Christian...........................
Other Religion............................
None...........................................
Highest Plann
at This Colle ed
ge
Parent/Guardian 1...................
Parent/Guardian 2...................
Retired
26. Current employment status:
(Mark one in each row)
Employed
Seasonal
ly
Employed
Unemploy
ed
Parent/Guardian 2 career
37. How often in the past year
did you?
(Mark one for each item)
34. Continued. In the past year,
how often have you: (Mark
one for each item)
ionally
`
Major (not sure I will have enough funds
to complete college)
ionally
HEALTHCARE SUPPORT
36 Dietician/Nutritionist
37 Home Health Worker
38 Medical/Dental Assistant
(e.g., Hygienist, Lab Tech,
Nursing Asst.)
39 Registered Nurse
40 Therapist (e.g., Physical,
Occupational, Speech)
Some (but I probably will have enough
funds)
Occas
GOVERNMENT
32 Military
33 Federal/State/Local
Government Official
34 Protective Services
(e.g., Homeland Security,
Law Enforcement, Firefighter)
35 Postal Worker
`
Highest Plann
ed
61 CLERGY
62 HOMEMAKER/STAY AT
HOME PARENT
63 OTHER
64 UNDECIDED
None (I am confident that I will have
sufficient funds)
32. Current religious preference:
(Mark one in each column)
$6,000-$
SERVICE INDUSTRY
55 Custodian/Janitor/Housekeeper
56 Food Service (e.g., Chef/Cook,
Server)
57 Hair Stylist/Aesthetician/
Manicurist
58 Interior Designer
59 Skilled Trades (e.g., Plumber,
Electrician, Construction)
60 Social/Non-Profit Services
`
ntly
EDUCATION
22 College Administrator/Staff
23 College Faculty
24 Early Childcare Provider
25 Elementary School Teacher
26 Secondary School Teacher in
Science, Technology,
Engineering, or Math (STEM)
27 Secondary School Teacher in a
non-STEM subject
28 Librarian
29 Teacher’s Assistant/
Paraprofessional
30 K-12 Administrator
31 Other K-12 Professional
SCIENCE AND ENGINEERING
52 Engineer
53 Research Scientist (e.g., Biologist,
Chemist, Physicist)
54 Urban Planner/Architect
Parent/Guardian 1 career
$3,000-$
COMMUNICATIONS
19 Journalist
20 Public Relations/Media
Relations
21 Advertising
MEDICAL PRACTITIONERS
46 Clinical Psychologist
47 Dentist/Orthodontist
48 Medical Doctor/Surgeon
49 Optometrist
50 Pharmacist
51 Veterinarian
Your intended career
9
BUSINESS
08 Accountant
09 Administrative Assistant
10 Business Manager/Executive
11 Business Owner/Entrepreneur
12 Retail Sales
13 Sales/Marketing
14 Human Resources
15 Finance (e.g., Actuary,
Banking, Loan Officer, Planner)
16 Management Consultant
17 Real Estate Agent/Realtor/
Appraiser/Developer
18 Sports Management
LAW
44 Lawyer/Judge
45 Paralegal
$1-$2,99
AGRICULTURE
06 Farmer or Forester
07 Natural Resource
Specialist/Environmentalist
INFORMATION TECHNOLOGY
41 Computer Programmer/Developer
42 Computer/Systems Analyst
43 Web Designer
None
ARTS
01 Actor or Entertainer
02 Artist
03 Graphic Designer
04 Musician
05 Writer/Producer/Director
31.Do you have any concern about your
ability to finance your college education?
(Mark one)
Freque
25. Please indicate your intended career
as well as the careers of your parents/
guardians, using the codes provided
on the attached fold out. (Your intended
career, Parent/Guardian 1 career, Parent/
Guardian 2 career)
25. Below is a list of different careers grouped into general
categories. (Fill in appropriate two-digit codes on your survey)
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
VSN
File Type | application/pdf |
Author | DPurnell |
File Modified | 2016-06-02 |
File Created | 2016-01-09 |