Postsecondary Student Interest Form
At what college are you currently enrolled:______________________________________________
When you graduate will you be receiving: ___AA degree ___AS degree ___BA degree ___BS degree
___Other (please indicate) ______________________________________________________________
Check all that apply: [ ] Female
[ ] Male
[ ] Disabled
[ ] African American or Black [ ] American Indian or Alaska Native
[ ] Pacific Islander [ ] Caucasian or White
[ ] Hispanic or Latino
[ ] Veteran
[ ] Asian American
Is the academic program you are currently enrolled in the area of:
[ ] science [ ] computing/technology [ ] engineering [ ] mathematics [ ] other ______________________
As a result of this presentation are you more interested in studying (check all that apply):
[ ] science [ ] computing/technology [ ] engineering [ ] mathematics [ ] other ______________________
As a result of this presentation are you more interested in pursuing a career in (check all that apply):
[ ] science [ ] computing/technology [ ] engineering [ ] mathematics [ ] other ______________________
On the back of this form describe how this workshop has changed how you feel about succeeding in college
and your interest in a certain field of study.
Postsecondary Student Interest Form
At what college are you currently enrolled:______________________________________________
When you graduate will you be receiving: ___AA degree ___AS degree ___BA degree ___BS degree
___Other (please indicate) ______________________________________________________________
Check all that apply: [ ] Female
[ ] Male
[ ] Disabled
[ ] African American or Black [ ] American Indian or Alaska Native
[ ] Pacific Islander [ ] Caucasian or White
[ ] Hispanic or Latino
[ ] Veteran
[ ] Asian American
Is the academic program you are currently enrolled in the area of:
[ ] science [ ] computing/technology [ ] engineering [ ] mathematics [ ] other ______________________
As a result of this presentation are you more interested in studying (check all that apply):
[ ] science [ ] computing/technology [ ] engineering [ ] mathematics [ ] other ______________________
As a result of this presentation are you more interested in pursuing a career in (check all that apply):
[ ] science [ ] computing/technology [ ] engineering [ ] mathematics [ ] other ______________________
On the back of this form describe how this workshop has changed how you feel about succeeding in college
and your interest in a certain field of study.