Student Post-Pilot Survey

NASA Explorer Schools (NES) Pilot Implementation Small Scale Evaluation Research Study

NES Pilot Student Survey_PrePilot (2)

Student Post-Pilot Survey

OMB: 2700-0139

Document [docx]
Download: docx | pdf

Do not write your name on this survey, or on the answer form.



NES Pilot Student Survey (Pre-Pilot)


Do not write your name of this survey, or on the answer form.


Part 1: Participant Identification


School Name: ___________________________


Circle Grade Level:

6 7 8 9 10 11 12


What is your gender? Check one.

___ Male

___ Female


What is your Ethnicity? Check one.

___ Hispanic or Latino

___ Not Hispanic or Latino


What is your Race? Check one or more.

___ American Indian or Alaskan Native

___ Native Hawaiian or other Pacific Islander

___ Asian

___ White

___ Black or African American



Part 2: Student experience, attitudes and expectations


Please indicate how much you agree with the following statements


Q1:  I am interested in NASA.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q2:  I am interested in Science.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree

Q3:  I am interested in Technology.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q4:  I am interested in Engineering.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q5:  I am interested in Mathematics.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q6:  I know a lot about NASA.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree







Q7:  I am good at Science.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q8:  I am good at Technology.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q9:  I am good at Engineering.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q10:  I am good at Mathematics.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q11:  I am interested in careers at NASA.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree








Q12:  I am interested in careers in Science.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q13:  I am interested in careers in Technology.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q14:  I am interested in careers in Engineering.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree


Q15:  I am interested in careers in Mathematics.


___ Strongly Disagree  

___ Disagree 

___ Neutral

___ Agree  

___ Strongly Agree
















Q16: Which NASA activity would be interesting to you? Check all that apply


___ High school internship/work at a NASA Center

___ Additional NASA classroom activities

___ College internship/work at a NASA Center

___ College research experience

___ Visit from a NASA educator, scientist, or engineer

___ Visit from a NASA astronaut

___ Seminar/lecture by a NASA or aerospace professional

___ Participate in a launch event

___ Video downlink from International Space Station of Space Shuttle

___ Radio call to an astronaut

___ Library lesson about NASA

___ NASA TV-based activity

___ NASA computer-based activity

___ Visit to a museum, science center or planetarium

___ Competition

___ Career fair

___ After school or club activity

___ Webcast

___ Videoconference

___ Other

___ I am not interested in future NASA experiences



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBenjamin Jones
File Modified0000-00-00
File Created2021-02-02

© 2024 OMB.report | Privacy Policy