First Name:
Last Name:
Address:
City/State:
Zip:
Phone:
E-mail: (required)
Where did you receive advisng/counseling from?
Online
Orange Park Campus
Palatka Campus
Ponte Vedra Campus
St. Augustine Campus
I learned about college polices and
procedures relevant to my situation.
4=Strongly agree
3=Agree
2=Disagree
1=Strongly Disagree
0=Does not apply
Resources and services were suggested.
(tutoring, career services,
CPT, CLEP, CLAST, etc.)
4=Strongly agree
3=Agree
2=Disagree
1=Strongly Disagree
0=Does not apply
I have an improved understanding of the
requirements needed to complete my
degree/certificate.
4=Strongly agree
3=Agree
2=Disagree
1=Strongly Disagree
0=Does not apply
I was encouraged to utilize Facts.org
as transfer to career tools.
4=Strongly agree
3=Agree
2=Disagree
1=Strongly Disagree
0=Does not apply
I am able to make informed decisions
about my education and career goals.
4=Strongly agree
3=Agree
2=Disagree
1=Strongly Disagree
0=Does not apply
I was introduced to (or reminded of) strategies that
promote success (time management skills, choosing
appropriate course load, study habits, etc).
4=Strongly agree
3=Agree
2=Disagree
1=Strongly Disagree
0=Does not apply
Credit hours completed
Not yet enrolled
Fewer than 15
Greater than 45
Continuing beyond degree
What brought you to counseling
(select all that apply):
Test Scores
Course selection
Degree information
Academic Hold(s)
Graduation
Transfer information
Personal
Career resources
Other (explain):
Ethnic Group (optional)
African American or Black American
Asian or Pacific Islander
Caucasian
Hispanic
Indian or Native Alaskan
Other
Gender (optional)
Female
Male
Please list any additional comments regarding other
Student Affairs Offices Activities, Financial Aid,
Admissions/Records, Academic Success/Retention
(workshops, tutoring, etc.).