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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
The CALWORKS program strives to provide quality support services to help students meet their educational
goals. As a part of our efforts to help students, we ask that you answer the questions below to the best of your
knowledge. Your honest responses to the questions will help you and the CALWORKS program staff.
INTRODUCTION
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
What is your current educational goal? (Select all that apply)
What is your current major? (If undecided, write "undecided")
When do you anticipate completing your educational goal(s)?
What is your primary career goal? (If undecided, write "undecided")
BACKGROUND INFORMATION
Term:
Year:
Earn an Associate's Degree (A.A. or A.S.)
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Transfer to a four-year college
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Earn a vocational certificate
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Undecided
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Do you participate in student clubs and campus activities?
Are you currently working?
Are you currently volunteering?
BACKGROUND INFORMATION
Yes
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No, but I would like to
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No, I am not interested
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If yes, what clubs or activities do you usually participate in?
Yes, I work full-
time
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Yes, I work part-
time
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No, I don't work
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If yes, where do you work?
Yes
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No
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If yes, where do you volunteer?
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Are you planning on attending WCC during the 2010-2011 academic year?
If you will NOT be attending WCC during 2010
-2011, why not?
If you WILL be attending WCC in 2010-2011, what services from CalWORKS will help you meet your Educational and Welfare-
to-Work requirements? (Select all that apply)
BACKGROUND INFORMATION
Yes
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No
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Not Sure
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I will have completed my program and/or degree
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I will transfer to a 4-year university
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Other (please specify)
Counseling
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Childcare Referrals
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Work
-Study/Employment Referrals
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Educational Supplies
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Books
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Parking/Bus Cards
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Other (please specify)
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Please check the counseling services you have received: (Select all that apply)
CALWORKS COUNSELING
- please select the answer that best reflects how you feel MOST of the time.
Strongly Agree
Agree
Disagree
Strongly Disagree
N/A
I am able to see my
CalWORKS counselor when
I need to.
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I feel comfortable with my
CalWORKS counselor.
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My CalWORKS counselor
provides me with accurate
information about my
educational and career
goals.
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My CalWORKS counselor is
interested in and cares
about my progress in
college.
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I am satisfied with the
services I have received
from my CalWORKS
counselor.
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I would recommend my
CalWORKS counselor to
other students.
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The progress reports I
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Individual Counseling Appointments
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Educational Planning
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Progress Reports
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Information Regarding CalWORKS, College and Community
Resources
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
receive are helpful.
I understand and comply
with the requirements of
the CalWORKS program.
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I am satisfied with my
Educational Plan.
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I know what I need to do
to achieve my Educational
Plan.
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My CalWORKS counselor is
knowledgeable about the
County and College
CalWORKS program
policies.
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Overall, CalWORKS
services are
useful/valuable to me.
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Your comments/suggestions on any area of the program will be helpful.
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Please select all the job placement services you have utilized: (Select all that apply)
If you did not use any of the job placement services listed previously, please tell us why: (Select all that apply)
CALWORKS JOB/WORK-STUDY PLACEMENT
Resume Development
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Application
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Mock interview
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Employment Leads
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Assistance with issues on the job
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Work
-Study (subsidized employment)
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I didn't know about the job placement services
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I was not referred
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I am not interested
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I don't have time to work
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I am not required to participate
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I am already employed and have no issues I need help with
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Other (please specify)
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
CALWORKS JOB PLACEMENT
- please select the answer that best reflects how you feel MOST of the time.
CALWORKS JOB/WORK-STUDY PLACEMENT
Strongly Agree
Agree
Disagree
Strongly Disagree
N/A
I am able to see the
CalWORKS Job Developer
in a timely manner.
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The CalWORKS Job
Developer communicates
with me in a manner that
helps me understand the
job placement services.
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I feel the CalWORKS Job
Developer accepts me and
understands my situation.
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I feel comfortable sharing
personal information
relevant to my job search
with the CalWORKS Job
Developer.
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If I were faced with a
work related issue, I feel
like the CalWORKS Job
Developer could help me.
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I am satisfied with the
services I receive from the
CalWORKS Job Developer.
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I am satisfied with the job
I obtained with the
assistance of the
CalWORKS Job Developer.
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I am satisfied with the job
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
placement process (time
lines, resume, mock
interview, etc.)
I am satisfied with my
resume.
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CalWORKS job placement
services will be an
important resource for me
when I start looking for
employment.
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Have you been placed by the CalWORKS Job Developer in a subsidized job/work-study?
Please select the answer that best reflects how you feel about your subsidized work-study position.
CALWORKS JOB/WORK-STUDY PLACEMENT
Very Satisfied
Satisifed
Dissatisfied
Very Dissatisfied
How satisfied are you with
the subsidized position
you received?
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How satisfied are you with
the job placement
services in obtaining your
subsidized position?
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Yes
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No
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Not Sure
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Ethnicity:
Age:
Comments or Suggestions:
OPTIONAL QUESTIONS
Gender:
Is this the first college you have attended?
Are you the first person in your family to attend college?
Female
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Male
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African-American
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Asian
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Hispanic
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Multi-Ethnic
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Native-American
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White
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Other (please specify)
<18
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18
-
20
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21
-
25
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26
-
30
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31
-
40
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41
-
50
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51
-
60
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>60
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Yes
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No
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If no, what college did you previously attend?
Yes
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No
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Hardcopy of CALWORKS Spring 2010 Student Self-Assessment Survey
Thank you for your time!