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Introductory Survey


Select your class:   9:00   10:00   11:00   Online

Lastname: Firstname: 

Name you wish to be called during this course: 

Address:  Street: 
                 City:     State:  Zip:
Email address: Local Telephone number:   
High School Graduated from:  City:
Academic Major:   Number of credit hrs. this quarter: 
Please check:
Class:      Freshman  Sophomore    Junior  Senior   Graduate / Other:
Sex:               Female    Male
Age:            18-19         20-21       22-25       26-30    31-35     35-39    40+
Race:       Asian    Black     Hispanic    White   /  Other: 
Relationship:Single  Married  Separated   Divorced   Widowed  Cohabit /               Other:
No. of Children:  
Educational/Degree Goal:  Associates    Bachelors    Masters    Doctorate /               Other:
Work Status:   Not employed   Part-time employed  Full-time employed  Self-employed   Volunteer
If employed or volunteering:  Place of business: 
 Type of job: How many hrs./week?   
Career goal/Type of work you hope to do: 

 Computer Experience

Do you have access to a computer where you are living locally?Yes   No
How would you rate your overall experience in using computers?  5 Very experienced    4 Somewhat experienced   3  Average    2 Somewhat inexperienced   1  Very inexperienced  0 No experience
How would you rate your experience in using the internet?  5 Very experienced    4 Somewhat experienced   3  Average    2 Somewhat inexperienced   1  Very inexperienced  0 No experience
How would you rate your experience in using email? 5 Very experienced    4 Somewhat experienced   3  Average    2 Somewhat inexperienced   1  Very inexperienced  0 No experience

Library Computer Searches                   

Have you had any experience with library computer searches in general? 
  Yes     No
Have you had any experience with PsychoINFO or Medline library search? 
  Yes     No

Enter any comments about library searches in the space provided below:

List the classes you are taking this quarter with the days, times, and hours:

 

List other psychology courses you have taken and indicate the instructor:

What are your reasons for taking this course?

What are your expectations for this course?

What is the most concern you have in this course or in school?

What topics would you like to have discussed during this course?

 Please click "Submit Information" bar ONLY ONCE and wait for CONFIRMATION PAGE to appear.


Dr. W. Griesinger
Copyright 2000 [University of Cincinnati]. All rights reserved.
Revised: November 23, 2003 .