Achievers & Scholars: Mentoring African American Males
Spring 2015
*Cohort 1 Pre-Assessment Questionnaire
This assessment is an opportunity for you to reflect on your past and potential experiences. This assessment asks
both academic and non-academic questions, because your college experience is impacted by academic and nonacademic situations. As you complete this assessment, keep in mind that this was designed to help find effective
ways to ensure your success. With that in mind, if you feel uncomfortable responding to any of these questions,
you do not have to answer them. However, try to be as open and honest as possible.
Name:
A #:
APSU Email:
Phone (cell # appreciated):
Your confidential responses help us better serve you and other students. Thank you!
A. In reviewing who you are as an African American male college student, what things are you concerned may
negatively impact your college experience?  Check all that apply.
Academic
29.4%
41.1%
0
17.6%
11.7%
11.7%
11.7%
0
17.6%
11.7%
Ineffective study skills
Ineffective test taking skills
Ineffective writing or reading skills
Undeveloped time management skills
Unprepared for exams
What worked in high school does not anymore
Hard to concentrate/daydreaming
Difficult classes/not prepared for course level
Connection with professor
Unable to understand course content or find
relevance in course material
0 Registered for too many classes
0 Unprepared for college work
29.4% Being the only African American male in classes
5%
29.4%
5%
5%
0
0
5%
Major/Career
Uncertain about current major
Austin Peay was not my first choice
Unsure what jobs are associated with major
No clear career goals
I am not confident that I made a wise decision
to attend college
Austin Peay may not be the place for me
Uncertain where my strengths lie
Personal/Other
11.7%
0
0
35.2%
0
0
11.7%
5%
23.5%
5%
11.7%
11.7%
0
0
5%
0
5%
0
47% Fear of failure
Financial difficulties
Health problems
Depression
Procrastination
Trouble learning “Who I Am”
Use or abuse of alcohol or other substance(s)
Possible learning disability
Lack of self-esteem
Pressure, stress, anxiety or tension
Excessive time spent online
(FaceBook, Twitter, YouTube, Gaming, etc.)
Over-whelmed by the thought of college
Lack of motivation
Working too much (# Hours/Week ______)
Family/Social Adjustment
Roommate issues
Personal relationship issues
Interpersonal violence
Family situation
Moved away from home/homesick
0 Difficulty adjusting to college life
5% Hard to make friends/Loneliness
Achievers & Scholars: Mentoring African American Males (Modified from Weber State University, Iowa State & University of NC forms.) 1/07/14 Page 1
Achievers & Scholars: Mentoring African American Males
Spring 2015
Please carefully answer each question so this confidential information can be used to best support you and other students.
B.  YOUR LEVEL OF AGREEMENT WITH THESE STATEMENTS.
I feel that Achievers & Scholars will help me:
1. Learn how to navigate APSU campus resources, services and facilities.
Strongly Agree
64.7%
Agree
17.6%
Disagree
Strongly Disagree
5%
0
2. Engage in academic and co-curricular activities.
Strongly Agree
70.5%
Agree
17.6%
Disagree
Strongly Disagree
0
0
3. Learn skills to manage their social development (motivation, advocacy, self-efficacy, self-esteem, etc.).
Strongly Agree
82.4%
Agree
1%
Disagree
Strongly Disagree
0
0
4. Make satisfactory progress towards degree completion.
Strongly Agree
76.8%
Agree
11.7%
Disagree
0
Strongly Disagree
0
Achievers & Scholars: Mentoring African American Males (Modified from Weber State University, Iowa State & University of NC forms.) 1/07/14 Page 2
Achievers & Scholars: Mentoring African American Males
Spring 2015
C. What are the top 3 things that you are excited about in regard to college?
1.
2.
3.
D. Please feel free to provide any additional comments below:
Thank You!
Achievers & Scholars: Mentoring African American Males (Modified from Weber State University, Iowa State & University of NC forms.) 1/07/14 Page 3
Achievers & Scholars: Mentoring African American Males
Spring 2015
Achievers & Scholars: Mentoring African American Males (Modified from Weber State University, Iowa State & University of NC forms.) 1/07/14 Page 4