Fillable IIB 37 Educate Survey 2013

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IIB 37 Educate Survey 2013

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File type: PDF

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Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
Educate Logo
THISEVENTISINTENDEDFORHIGHSCHOOLSTUDENTS.
Thankyouforyourinterestinattendingthe2013Educate

SiSePuedeConferenceatCuestaCollege.Thisspecialeventwillfeatureinspiring,
andexcitingguestspeakersoncareerpaths,goingtocollegeandsomuchmore!
Pleasetakethetimetoanswerallofthequestionsbelow.Onceyouhavecompletedtheregistration,printoutthePARENTPERMISSIONSLIP,fill
itoutwithyourparentsandturnitintoyourHScounselororconferencecoordinator.Youmustdothistobeeligibletoattend.
Welookforwardtomeetingyousoon!
1.
Contact Information
2. Re
Enter Your Email Address:
3. Listing for Name Tag (First name or nickname):
PleaseanswerthequestionsbelowtohelpuscreatethebestexperienceforEducate
SiSePuede.
*
Name:
Address:
Address 2:
City/Town:
State:
6
ZIP:
Email Address:
Cell Phone for Text
Updates:
*
*
Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
4. Have you Attended the Educate

Si Se Puede Conference in the past?
5. How did you find out about the Educate

Si Se Puede Conference?
6. What Size T
Shirt do you want?
7. Do you need a vegetarian lunch?
8. Do you have any special needs or accomodations we should know about?
*
*
*
*
5
5
6
6
Yes
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No
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HSCounselororTeacher
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FriendorFamily
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CuestaCounselororStaff
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Newspaper,TV,Radio,orWebsite
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Flier
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Other
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X
Small
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Small
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Medium
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Large
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X
Large
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XX
Large
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Yes
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No
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Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
9. What is the name of your high school?
10. What grade are you in?
11. What is your birth date (MM/DD/YY)?
12. Are you male or female?
*
*
*
*
AtascaderoHS
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PioneerValleyHighSchool
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PasoRoblesHS
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PacificBeachHS
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ShandonHS
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NipomoHS
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WestMallAlternative/DelRioHS
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SanLuisObispoHS
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TempletonHS/TempletonIndependent/EagleCanyon
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LopezContinuationHS
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IndependenceHS/LibertyHS
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ArroyoGrandeHS
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CoastUnionHS
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MorroBayHS
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LeffingwellHS
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Other
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NotinSchool
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Other(pleasespecify)
9
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10
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11
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12
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NotinSchool
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Male
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Female
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Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
13. Ethnicity/Race (Select ALL that apply)
14. Were you born in the United States?
15. If you answered No to above question, where were you born?
16. Were one or more of your parents born in the United States?
17. Were one or more of your grandparents born in the United States?
18. What language do you mainly speak at home?
*
*
Mexican,Mexican
American,Chicano
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CentralAmerican
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SouthAmerican
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Hispanic:Other
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Asian:Indian
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Asian:Chinese
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Asian:Japanese
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Asian:Korean
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Asian:Laotian
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Asian:Cambodian
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Asian:Vietnamese
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Filipino
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Asian:Other
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BlackorAfricanAmerican
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NativeAmerican/AlaskanNative
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PacificIslander:Guamanian
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PacificIslander:Hawaiian
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PacificIslander:Samoan
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PacificIslander:Other
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White
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Yes
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No
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Yes
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No
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Yes
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No
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English
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Spanish
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Other(pleasespecify)
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Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
19. What is the second language you speak most often? (Secondary language)
20. What is the highest level of schooling your mother completed (or guardian #1)?
21. What is the highest level of schooling your father completed (or guardian #2)?
*
English
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Spanish
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None
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Other(pleasespecify)
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Grade9orless
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SomeHighSchool,nodiploma
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HighSchooldiploma,GED,orequivalent
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Somecollegecredit,nodegree
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Associate'sDegree(AA,AS)
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Bachelor'sDegree(BA,BS)
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Graduate/ProfessionalDegreebeyondBachelor'sDegree
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Don'tKnow
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Grade9orless
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SomeHighSchool,nodiploma
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HighSchooldiploma,GED,orequivalent
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Somecollegecredit,nodegree
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Associate'sDegree(AA,AS)
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Bachelor'sDegree(BA,BS)
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Graduate/ProfessionalDegreebeyondBachelor'sDegree
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Don'tKnow
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Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
22. What do you plan on doing right after you graduate from high school?
23. What is your biggest challenge to reaching your goals?
24. Who helps you the most when you need support/advice?
25. How much do you know about starting college?
*
*
*
*
Iplantogotoa4yearcollegeoruniversity
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Iplantogotocommunitycollege
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IplantogotoaTradeorVocationalSchool(ex.Culinary,Cosmetology,AutomotiveSchool,etc)
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Iplantogetajob
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Iplantojointhemilitary
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Other(pleasespecify)
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Academics(schoolwork,studyskills,abilitytounderstandandcompleteassignments)
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PeerIssues(personalrelationships,drug/alcoholabuse,gangs)
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Myimmigrationstatus
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Familyissues/beliefs
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Languagebarriers
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Financial(beingabletoaffordcollege)
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Other(pleasespecify)
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Teachers,Counselor,orAdultMentor
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Friends
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Parents
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BrotherorSister
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None
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Other
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Iamreadytogo!IhavealltheinfoIneed.
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Ihavesomeinformation,butneedmore.
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Ihavenoclue.
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Educate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se PuedeEducate-Si Se Puede
26. How much do you know about getting money to go to college?
27. How important is it that the college/university you want to attend provides materials
in Spanish?
28. How important is it that the college/university you want to attend has cultural
activites or clubs?
29. How important is it that the college/university you attend has bilingual or Latino staff
available to help you?
30. What kinds of things or activities should a college/university have to make sure that
you feel welcome on campus?
*
*
*
*
Iamreadytogo!IhavealltheinfoIneed.
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Ihavesomeinformation,butneedmore.
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Ihavenoclue!
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VeryImportant
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SomewhatImportant
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NotImportant
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VeryImportant
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SomewhatImportant
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NotImportant
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VeryImportant
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SomewhatImportant
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NotImportant
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IIB 37 Educate Survey 2013

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Completed 13 February 2020

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