This survey is intended to help us better serve your needs. Feel free to leave blank any item (including name) you prefer not to answer for privacy reasons.

Name _______________________________________________

1. Student status:

¢ Undergrad

¢ Evening MS program

¢ Non-matriculated

¢ Full-time PhD program

¢ Auditing

 

2. Gender

¢ M

¢ F

 

3. Age

¢ -25

¢ 25-35

¢ 35-45

¢ 45-55

¢ 55-

 

4. Approximately how far do you travel from home or work to this class?

¢ less than 10 miles

¢ 10-20 miles

¢ 20-50 miles

¢ more than 50 miles

 

5. Educational background

¢ No college degree

¢ Bachelor’s degree

¢ Master’s degree

¢ PhD or other doctorate

 

6. Majored in…

¢ Physics or Astronomy

¢ Other physical sciences (subject: __________________)

¢ Engineering (subject: __________________)

¢ Math, statistics or computer science

¢ Life sciences or social sciences (subject: __________________)

¢ Education

¢ Humanities/liberal arts (subject: __________________)

¢ Fine arts (subject: ____________________)

¢ Other: __________________________

 

7. Employment

¢ Self-employed

¢ Full time job (employer(s):_______________________________________)

¢ Part time employment (by choice)

¢ Part time employment (seeking full time)

¢ Unemployed

¢ Retired

¢ Full time student (with or without part time job)

 

8. Goals

¢ Preparing for entry to another program

¢ MS degree

¢ PhD degree

¢ Professional development (but no degree)

¢ Just interested in physics