EXIT SURVEY
Section 1-Demographics
Date
*
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Month
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Day
Year
Date
Name (optional, but adding your name allows us to make changes that benefit you directly)
First Name
Last Name
Gender Identity
*
Female
Male
Non-binary
Other
Prefer not to say
Racial Background
*
Indigenous (including First Nations, Metis, Inuit)
White (including European Descent)
African-Canadian
Hispanic
Middle Eastern
South Asian
South East Asian
Biracial
Prefer not to say
Do you identify with the LGBTQIA2S+ Community?
*
Yes
No
Prefer not to say
Reason for, leaving/not coming to, the centre
*
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Section 1-Reflections on the Centre
In reflection, did you achieve your academic goals while with us?
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1-no, 10-exceeded expectations
Did the extra curricular programs support your learning objectives?
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1-poor, 10-exceeded expectations
Would you recommendt this centre to someone?
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1-no, 10-yes
Rate your overall satisfaction with the centre?
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10
1-poor, 10-exceeded expectations
Optional-Please provide comments/feedback/suggestion related to your overall satisfaction scores
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Next
Section 2- Reflections on Programming and Instruction
Did you meet your learning objectives in English?
*
Yes
No
Prefer not to say
Not applicable
Did the English program meet, exceed, or not meet your expectations? (optional, leave blank if not applicable)
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1-poor, 10-exceeded expectations
Did the level of English instruction meet your individual needs?
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10
1-no, 10-exceeded expectations
Rate the quality of English instructional methods
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10
1-poor, 10-exceeded expectations
Rate the overall quality of English instruction
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10
1-poor, 10-exceeded expectations
Did you meet your learning objectives in Math?
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Yes
No
Prefer not to say
Not applicable
Did the Math program meet, exceed, or not meet your expectations? (optional, leave blank if not applicable)
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1-poor, 10-exceeded expectations
Did the level of Math instruction meet your individual needs?
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10
1-no, 10-exceeded expectations
Rate the quality of Math instructional methods
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10
1-poor, 10-exceeded expectations
Rate the overall quality of Math instruction
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10
1-poor, 10-exceeded expectations
Did you meet your learning objectives in Social Universe (history, contemporary world, etc)?
*
Yes
No
Prefer not to say
Not applicable
Did the Social Universe (history, contemporary world, etc) programs meet, exceed, or not meet your expectations? (optional, leave blank if not applicable)
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10
1-poor, 10-exceeded expectations
Did the level of Social Universe instruction meet your individual needs?
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10
1-no, 10-exceeded expectations
Rate the quality of Social Universe instructional methods
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10
1-poor, 10-exceeded expectations
Rate the overall quality of Social Universe instruction
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10
1-poor, 10-exceeded expectations
Did you meet your learning objectives in Computer Sciences?
*
Yes
No
Prefer not to say
Not applicable
Did the Computer Sciences programs meet, exceed, or not meet your expectations? (optional, leave blank if not applicable)
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10
1-poor, 10-exceeded expectations
Did the level of Computer Science instruction meet your individual needs?
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10
1-no, 10-exceeded expectations
Rate the quality of Computer Sciences instructional methods
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10
1-poor, 10-exceeded expectations
Rate the overall quality of Computer Sciences instruction
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10
1-poor, 10-exceeded expectations
Did you meet your learning objectives in Sciences?
*
Yes
No
Prefer not to say
Not applicable
Did the Science programs meet, exceed, or not meet your expectations? (optional, leave blank if not applicable)
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10
1-poor, 10-exceeded expectations
Did the level of Science instruction meet your individual needs?
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10
1-no, 10-exceeded expectations
Rate the quality of Science instructional methods
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10
1-poor, 10-exceeded expectations
Rate the overall quality of Science instruction
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10
1-poor, 10-exceeded expectations
Optional-Please provide comments/feedback/suggestion related to your programming scores
Optional-Please provide comments/feedback/suggestion related to your Instruction scores
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Section 3-Your comments
Despite leaving early for any reason, would you consider rejoining or enrolling again?
*
Yes
No
Maybe
Optional-Based on your above answer, what would make the difference for you in order to see you return?
Optional-Please provide any suggestions or comments on how we can improve our adult education program to better meet the needs of our students
Optional-Is there anything else you would like to share about your experience with our adult education centre and program?
Submit
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