PCTC Student Exit Survey - Contact Informtion

Thank you for taking the time to complete this survey. Your feedback is valuable to us as we want to ensure we continue to provide the best educational experience for our students. Please be honest and open in your responses.

1. Contact Information *This question is required.

First Name

Last Name

Street Address

Apt/Suite/Office

City

State

Zip

Email Address

Phone Number

Additional Phone Number

2. Permanent Address and Contact Information of a Family Member / Relative
(Possibly a Spouse, Grandparent, or other relative who is not likely to move in the next five years)

First Name

Last Name

Street Address

Apt/Suite/Office

City

State

Zip

Phone Number

Mobile Phone

E-Mail address

4. What Course did you take at PCTC? *This question is required.

5. Choose the answer that best describes you at the point you are exiting the program *This question is required.

I am finishing the program
If dropping the program before finishing please list a brief reason:
I am dropping from the program before finishing Please enter an 'other' value for this selection.

6. Check the boxes if you received, or will soon be receiving the following from PCTC:

Diploma
Certificate of Hours
Advanced Credentials

7. Check the box or boxes that describes your future plans and include any details if possible. *This question is required.

2 Year Community / Technical College Where? What are you planning to study? Please enter an 'other' value for this selection.
4 Year College / University Where? What are you planning to study? Please enter an 'other' value for this selection.
Employed in field training / Where? Please enter an 'other' value for this selection.
Employed out of field training / Where? Please enter an 'other' value for this selection.
Military / Branch? Please enter an 'other' value for this selection.
Seeking Employment / Specify details if you have them. Please enter an 'other' value for this selection.
Other / Specify details if you have them. Please enter an 'other' value for this selection.
Return to PCTC / List Program: Please enter an 'other' value for this selection.

PCTC Student Exit Survey - Contact Informtion

PCTC Student Exit Survey - Contact Information Sheet