Form PC-2145 Application Complete Survey

OMB Control Number: 0420-0545

Expiration Date: 9/30/2017

VRS Survey 1: Application Complete

The purpose of this survey is to gather information related to your initial experience with the Peace Corps. The information you provide is voluntary and you are free to not answer any of the following questions. In addition, your responses are anonymous and will be reported in a way that ensures that you will not be personally identifiable by the answers that you provide.

Public reporting burden for this information collection is estimated to average 5 minutes.  The Peace Corps may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: the FOIA Officer, Peace Corps, 1111 20^th Street NW, 2^nd Floor, Washington, D.C. 20526 or [email protected].

Please indicate the extent to which you agree or disagree with each statement:
	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree	Not Applicable
The information provided in the Volunteer Job Opening was clear and informative.						
It was easy to complete my application to the Peace Corps online.						

Please indicate to which extent you agree or disagree with the following statement in conjunction with the factors listed below.  The following factors influenced my decision to apply to the Peace Corps:
	Strongly Agree	Agree	Neither Agree or Disagree	Disagree	Strongly Disagree	Not Applicable
Speaking with a Peace Corps Recruiter						
Attending Peace Corps Event or Informational Session						
Speaking with a Peace Corps Campus Ambassador						
Participation in a Peace Corps Prep program at my school						
Content from Peace Corps.gov						
Content from Peace Corps Social Media (Facebook, Twitter, etc.)						

To conclude this survey, we would like to ask you a few demographic questions. As with all questions on this survey, your responses are anonymous and will be reported in a way that ensures that you will not be personally identifiable by the answers that you provide. If you do not feel comfortable sharing your demographic information, however, you are always free to skip or select "Prefer not to answer" for any of the following questions.

GENDER

What is your gender?
	Male
	Female
	Prefer not to answer

ETHNICITY

Are You Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)
	Yes
	No
	Prefer not to answer

RACE

Please select the racial category or categories with which you most closely identify by placing an “X” in the appropriate box. Check as many as apply.
	American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
	Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
	Black or African American. A person having origins in any of the black racial groups of Africa.
	Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
	White.  A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
	Prefer not to answer

AGE

What is your age?
	18 to 25
	26 to 30
	31 to 35
	36 to 45
	46 to 55
	56 to 65
	65+
	Prefer not to answer

REGION

In which state do you live? [DROPDOWN LIST OF STATES, RECODE INTO REGION, INCLUDE PREFER NOT TO ANSWER]
	Dropdown list of States including territories
	I live outside of the United States
	Prefer to not to answer

PC – 2145