CNA CEU Student Survey
Student Name: *
Your answer
What is your Date of Birth?
example: month/day/year = 3/15/1965
Your answer
What is your current employment status? *
Click on the circle that applies to you, the circle will be filled in with a color when you click on it.
Are you Hispanic or Latino? *
Race: *
Select one or more boxes that apply
Required
How many years of school have you completed?
example: middle school = 6 years, completed high school = 12 years, some college = 14 years
Your answer
Most of my schooling was outside of the U.S: *
Highest Certificate, Diploma, or Degree Earned:
Click on the circle that applies to you
I earned the above certificate/diploma/degree outside of U.S.:
What is your Native Language?
Click on the circle that applies to you
What is your Primary/First goal by taking our classes? *
Click on the circle that most applies to you
Which Special Programs apply to you?
Click on one or more boxes that applies to you.
Which Employment Barriers apply to you?
Click on one or more boxes applies to you or leave all blank if none apply
Which of these Personal Status apply to you?
Click on one or more boxes applies to you or leave all blank if none apply
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