10-10128 Advanced Education Veteran Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

SOU-SORCC-Patient-Survey

Extended Hours Program Evaluation, Maternity Care Coordination, Advanced Education Veteran Survey, State Veterans Home Administrator Survey, VOV Conjoint Survey

OMB: 2900-0770

Document [docx]
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OMB Number 2900-0770

Estimated Burden: 5 mins

EXP Date: XX/XX/2014







Advanced Education Veteran Survey


OMB 2900-0770

Estimated burden: 5 minutes

Expiration Date xx/xx/xxxx



The Paperwork Reduction Act of 1995: This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average five (5) minutes. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery by helping to achieve services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.





VA Form 10-10128



























Southern Oregon University and Southern Oregon Rehabilitation Center and Clinics Program Offering Survey


Informed Consent - Electronic Survey


Welcome to the Southern Oregon University and Southern Oregon Rehabilitation Center and Clinics program offering survey. Brad Christ of the Information Technology department at Southern Oregon University is conducting this research. The results of the survey will provide important information about your university experience and help create a better environment for working and learning.


No personal information will be collected. All information is strictly confidential and will be protected to the degree permitted by the technology used (e.g. IP addresses will be stripped when the survey is submitted).


Only group data will be reported, meaning the analysis will include only aggregate data. Results will be statistically compiled. No names will ever be used in any report of the results of this study. The aggregate data will be analyzed and may be presented at professional conferences.


If you have questions about the research project and/or you would like to see the results of this project, contact Brad Christ at (541) 552-6451 or [email protected]


Your participation is voluntary and you may stop taking this survey at any time without penalty. The survey should take less than 5 minutes to complete. Please print a copy of this page for your records.


By continuing, you are confirming that you are at least 18 years old and are giving your informed consent to participate in the study.





How interested are you in taking courses from Southern Oregon University, whether on-campus, at Southern Oregon Rehabilitation Center and Clinics, or online?

  • Shape1 Very interested

  • Shape2 Interested

  • Shape3 Somewhat interested

  • Shape4 No interest



If you are interested in taking courses, what type(s) of programs would you like to enroll in?

  • Shape5 Non-degree seeking (classes only). All SOU courses are 10 weeks long.

  • Shape6 Certificate (1 to 2 years)

  • Shape7 Accelerated bachelor's degree (3 years)

  • Shape8 Bachelor's degree (4 years)

  • Shape9 Graduate degree (2 years, requires bachelor's degree)

  • Shape10 Other (please specify)Shape11



What areas of study are you most interested in?
(click and drag the areas of study from the left to the right)

Items

  • Accounting

  • Business

  • Computer Science

  • Communication

  • Counseling

  • Criminology and Criminal Justice

  • Degree Completion

  • Environmental Studies

  • Marketing

  • Nursing

  • Psychology

  • Outdoor Adventure Leadership

  • Social Work

I am interested in:

Did we miss an area of study that you would like to see offered? If so, please list it below:






Where would you prefer to take courses from Southern Oregon University?

(select all that apply)

  • Shape12 At the SORCC campus in White City

  • Shape13 At the SOU campus in Medford

  • Shape14 At the SOU Campus in AShland

  • Shape15 Hybrid course that meets both on-campus (any location) and online

  • Shape16 Online

  • Shape17 Other (please specify)Shape18





For in-person courses, what times would be the most convenient for you to attend?

  • Shape19 8am-5pm, Monday through Friday

  • Shape20 5pm-10pm, Monday through Friday

  • Shape21 Weekend days

  • Shape22 Other (please specify)Shape23





When would you like to enroll in a program at SOU?

  • Shape24 As soon as possible

  • Shape25 In a month or two

  • Shape26 In three to four months

  • Shape27 In six months

  • Shape28 Over six months from now

  • Shape29 Other (please specify)





What are your long term educational and career goals? What courses, certificate, or degree will you need to achieve those goals?






File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBrad Christ
File Modified0000-00-00
File Created2021-01-27

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