Select current quarter you are enrolled in: 

1.  What is your gender?
Male   Female

2.  What is your age?
Under 18   18-21    22-30    31-49   50 or above

3.  What is your ethnic origin?
American Indian or Alaskan Native   Black or Afro-American  
Chinese   Filipino   Japanese   Korean  
Native Hawaiian or other Pacific Islander   Vietnamese  
White   Other Asian   Other Race  

4. Are you of Spanish or Hispanic origin?
Yes, Mexican, Mexican-American, Chicano
Yes, Puerto Rican   Yes, Cuban   Yes, other Spanish/Hispanic  
No  

5.  What is your present marital status?
Never Married   Married/Partnered
Separated   Divorced   Widowed  

6.  How many dependents do you have?
None   One    Two    Three or more

7.  What is your employment status?
Not employed   Employed part-time   Employed full-time
Self-employed   More than one job

8.  Is this your first quarter enrolled at SSCC?
Yes   No

9.  What is the highest level of education that you have completed?
Some high school   High school graduate    Some college
Associate's Degree   Bachelor's Degree   Graduate Study

10.  How many years since you last attended school or college?
Less than 1   1-3   4-6    7-9   10 or more

11.  How did you find out about this distance learning course?
Quarterly schedule  At registration  Advisor  Seattle Weekly 
Continuing Education schedule  Flyer / brochure  Website / homepage 

12.  Please select any of the following that were important academic reasons that you enrolled in a distance learning course (choose all that apply):
Traditional sections closed
SSCC degree/certificate requirement
Personal interest / self-development
Need continuing/professional education credits
Job training

13.  Please select any of the following that were important personal reasons for enrolling in a distance learning course (choose all that apply):
Transportation concerns
Child care concerns
Illness / injury / disability
Work schedule conflicts with traditional sections
Preferred method of study
Convenience

14.  How many credits are you taking (including distance learning courses) this quarter?
1-3   4-6   7-9    10-12   13 or more

15.  How many distance courses are you taking this quarter?
1   2   3 or more

16.  Is this your first distance course?
Yes   No

17.  Are you currently enrolled in any courses other than distance courses?
Yes   No

18.  In what college or university, other than SSCC, are you currently enrolled?
Other Community Colleges   University of Washington  
Other college or university   None

19.  Do you have cable TV where you reside?
Yes   No

20.  If you are taking a video cassette course, how do you intend to view the video programs?
At home, receiving through TV without cable hook-up
At home, receiving through TV with cable hook-up
Recording programs on video and viewing them later
At the SSCC library
Renting a set of tapes to view at home
Does not apply

21.  If this distance course had not been offered, I would have:
Enrolled in another distance course
Enrolled in an on-campus course in the same academic area
Enrolled in an on-campus course in a different academic area
Not enrolled in another course

22.  What is your goal in attending college?
Seeking AA Degree  Working Toward Bachelor's Degree
Professional Upgrading  Continuing Education units required by profession
Personal Growth

23.  With reference to your home computer capabilities, please check all that apply:
CPU is 486   CPU is Pentium/Celeron   CPU is Mac/other
Monitor is color Monitor is black & white
Have CD ROM drive
Have sound card  Have speakers
Modem is 14.4   Modem is 28.8   Modem is 56  
Modem is Cable/DSL/Satellite Have other Internet Connection

24.  What is your zip code?
 

25.  Additional Comments:
 

26.  Treat this survey as anonymous
    OR enter First Name: 

28.   Last Name:  

29.   Enter Email (if you wish to be kept informed of changes in Distance Program):