SSS Contact Form
Responses will be used to help us improve our services and better understand your needs!
Name
*
First Name
*
Last Name
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
TRIO Staff
*
Please Select
Allred
Bowles
Champe
Cary
Gray
Reed
Tolliver
What service did you receive today?
*
Please Select
Academic Support/Tutoring
Advising/Coaching with Classes
Computer Lab Usage
Financial Literacy & Information
Orientation/Intake Assessment
Personal Coaching/Support
Referral
Information/Technology/Lab Assistance
Other
How were services provided?
*
Please Select
In Person/Office
Telephone
Virtual
Time In
*
Hour Minutes
AM
PM
AM/PM Option
Time Out
*
Hour Minutes
AM
PM
AM/PM Option
Feedback
*
Rows
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Flexible appointment times
Sufficient knowledge of subject
Explained material in a manner I understand
Comfortable with asking questions
Received adequate help to meet my needs
Shows an all around interest in my academic success
Suggested graduation assistance
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