Form 3 HERI Your First College Year

OMB #0925-XXXX
EXP. XX/XXXX

Attachment 10:
HERI Your First College Year

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Block 0

University of California, Los Angeles
YOUR FIRST COLLEGE YEAR (YFCY) SURVEY INFORMATION
SHEET
Purpose of the Study
You are asked to complete this survey as part of a national study conducted by the Higher
Education Research Institute (HERI) at the University of California, Los Angeles. This study is
designed to explore students’ academic involvement, social activities, health and wellness, and
interaction with faculty and peers during the first college year. Your college or university may then
use this information to improve their services for first-year students and better design first-year
programs and classes. The ultimate goal is to enhance student life in the first college year.
Procedures
To participate in this study, please complete and submit the following survey. Most
respondents complete this questionnaire in about 45 minutes, although individual progress will
vary by how quickly you move through the questions.
You may decide not to complete the survey for any reason at any time without consequence of any
kind. The Higher Education Research Institute does not offer payment for participation. Your
participation and responses to the questionnaire indicate your consent to participate in the study.
We ask for your name and address so that the researchers at UCLA can contact you at some later
date for follow-up study.
Potential Benefits to Subjects and/or Society
You may have the opportunity to reflect on your experiences in college as you complete the survey,
which may enhance self-understanding. Your responses to the survey also may help to improve the
first year of college at campuses across the country.
Potential Risks and Discomforts
There could be survey items that you are uncomfortable answering or to which you would simply
prefer not to respond. Your participation in this study is strictly voluntary, and you will be under
no obligation whatsoever to answer any questions that you are not inclined to answer. You may
choose

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not to answer any specific questions you do not want to answer and still remain in the study.
Information Protection
Please note that your responses will be used for research purposes only and will be protected. Any
information that is obtained in connection with this study and that can be identified with you will be
protected and secured to the extent permitted by law. Your identified responses will be returned to your
institution for institutional assessment purposes. Before receiving any responses your school is required
to certify in advance that the data will only be used for research purposes and will not be used to
investigate specific individuals. Names and addresses will not be returned to your instituion, however
Student ID numbers will be included in the final data file to allow your institution to merge responses
with other campuse data.
Identification of investigators
If you have any questions or concerns about the research, please contact the Interim Managing Director
of HERI, Dr. Kevin Eagan at this address:
Higher Education Research Institute
UCLA Graduate School of Education and Information Studies Box 951521
Los Angeles, CA 90095-1521
Email: [email protected]
Phone: 310-825-1925
Rights of Research Subjects
You may withdraw your consent at any time and discontinue participation without penalty. You are not
waiving any legal claims, rights or remedies because of your participation in this research study. If you
have questions regarding your rights as a research subject, contact the UCLA Office for Protection of
Research Subjects, 11000 Kinross Avenue, Suite 102, Box 951694, Los Angeles, CA 90095-1694, (310)
825-7122.
Public reporting burden for this collection of information is estimated to average 45 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. An
agency 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: NIH, Project Clearance Branch, 6705 Rockledge
Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx*). Do not return the completed
form to this address.
Do you consent to participate in the 2016 Your First College Year Survey?
Yes, please take me to the survey
No, I wish to opt out

Welcome to the 2016 Your First College Year Survey
Welcome to the 2016 Your First College Year Survey. This survey is a partnership between your
institution and the Higher Education Research Institute at the University of California, Los Angeles.

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Thank you for your participation. Your opinion and feedback matter!
Please click "next" to access the survey. To review your response to a previous question, click the "back"
button.

Default Question Block

Please provide the following information:

First Name

Last Name

Student ID
Date of Birth (MM/DD/YYYY)

For Spring 2016, were you still enrolled at ${e://Field/InstitutionName}?

Yes
No

In Spring 2016, did you take classes at a different college/university?
Yes
No

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Block 2

Your sex:
Male
Female

Are you:
(Mark all that apply)
White/Caucasian
African American/Black
American Indian/Alaska Native
East Asian (e.g., Chinese, Japanese, Korean, Taiwanese)
Southeast Asian (e.g., Cambodian, Vietnamese, Hmong, Filipino)
South Asian (e.g., Indian, Pakistani, Nepalese, Sri Lankan)
Other Asian
Native Hawaiian/Pacific Islander
Mexican American/Chicano
Puerto Rican
Other Latino
Other

Do you identify as multiracial?
Yes
No

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Do you identify as transgender?

Yes
No

What is your sexual orientation?
Heterosexual/Straight
Gay
Lesbian
Bisexual
Queer
Other

Are you currently a full-time or part-time student?
Full-time
Parttime
Not enrolled

What year did you first enter:
(Mark one in each row)

2014 or 2015

2010 or
earlier

Your 1st college
This college
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How often in the past year did you:
(Mark one in each row)
Not at All
Ask questions in class
Support your opinions with a logical argument
Seek solutions to problems and explain them to others
Revise your papers to improve your writing
Evaluate the quality or reliability of information you received
Take a risk because you felt you had more to gain
Seek alternative solutions to a problem
Look up scientific research articles and resources
Explore topics on your own, even though it was not required for
a class
Accept mistakes as part of the learning process
Seek feedback on your academic work
Integrate skills and knowledge from different sources and
experiences

Since entering this college, how often have you interacted with the following people (e.g.,
by phone, e-mail, text, or in person):
(Mark one in each row)
2 or 3
times per

Once a
week

1 or 2
times per
month

1 or 2
times per
term

Never

Faculty during office hours
Faculty outside of class or office
hours
Academic advisors/counselors
Close friends at this institution
Close friends not at this institution
Your family
Graduate students/teaching
assistants
Close friends from your high
school
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Do you have any concern about your ability to finance your college education?
None (I am confident that I will have sufficient funds)
Some (but I probably will have enough funds)
Major (not sure I will have enough funds to complete college)

How much of the past year's educational expenses (room, board, tuition, and fees) were
covered from each of the following sources? (Mark one answer for each possible source)

$1 to

$10,000
or more

Family resources (parents, relatives, spouse,
etc.)
My own resources (income from work, workstudy, etc.)

Aid which need not be repaid (grants,
scholarships, military, etc.)
Aid which must be repaid (loans, etc.)
Other sources

Since entering this college, how often have you felt:
(Mark one in each row)
Not at all
Lonely or homesick
Isolated from campus life
Unsafe on this campus
Worried about your health
That your courses inspired you to think in new ways
That your job responsibilities interfered with your schoolwork
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That your family responsibilities interfered with your
schoolwork
Family support to succeed
That faculty provided me with feedback that helped me assess
my progress in class
That my contributions were valued in class
That faculty encouraged me to ask questions and participate in
discussions

Please rate your satisfaction with this institution on each of the aspects of college life
listed below:
(Mark one in each row)

Satisfied Satisfied

Neutral Dissatisfied Dissatisfied

General education and core
curriculum courses
Your overall academic experience
Classroom facilities

Computer facilities/labs
Library resources
Laboratory facilities and equipment
Technology resources
Academic advising
Student housing (e.g., res. halls)
Financial aid office
Financial aid package

Student health services
Student psychological services
Orientation for new students
Opportunities for community
service
First-year programs (e.g., first-year
seminar, learning community,

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Rate yourself on each of the following traits as compared with the average person your
age. We want the most accurate estimate of how you see yourself.
(Mark one in each row)

Highest 10%

Above

Below

Lowest 10%

Academic ability
Artistic ability

Computer skills
Cooperativeness
Creativity
Drive to achieve
Emotional health
Leadership ability
Mathematical ability
Physical health

Popularity
Public speaking ability
Risk-taking
Self-confidence
(intellectual)
Self-confidence (social)
Self-understanding
Spirituality
Understanding of others

Since entering this college, how has it been to:
(Mark one in each row)

Very Easy

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Easy

Difficult

Very

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Understand what your professors expect of you
academically
Develop effective study skills
Adjust to the academic demands of college
Manage your time effectively
Develop close friendships with other students

How would you rate yourself in the following areas:
(Mark one in each row)
A Major

A Major
Weakness

Ability to see the world from someone else's
perspective
Tolerance of others with different beliefs
Openness to having my own views challenged
Ability to discuss and negotiate controversial
issues
Ability to work cooperatively with diverse people

Since entering this college, how often have you:
(Mark one in each row)
Not at all
Attended a religious service
Been bored in class
Demonstrated for a cause (e.g., boycott, rally, protest)
Studied with other students
Smoked cigarettes
Drank beer
Drank wine or liquor
Felt overwhelmed by all you had to do
Felt depressed
Performed volunteer work
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Asked a professor for advice after class

Since entering this college, how often have you:
(Mark one in each row)
Not at all
Worked on a local, state, or national political campaign
Socialized with someone of another racial/ethnic group

Come late to class
Posted on a course-related on-line discussion board
Performed community service as part of a class
Discussed religion
Discussed politics
Maintained a healthy diet
Had adequate sleep
Helped raise money for a cause or campaign

Publicly communicated your opinion about a cause

Please indicate the extent to which you agree or disagree with the following statements:
(Mark one in each row)

Agree

Strongly

I have felt discriminated against at this institution
because of my race/ethnicity, gender, sexual
orientation, or religious affiliation
I see myself as part of the campus community
Faculty showed concern about my progress
There is a lot of racial tension on this campus
I have been able to find a balance between academics
and extracurricular activities
The admission/recruitment materials portrayed this
campus accurately
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Faculty empower me to learn here

If asked, I would recommend this college to others
At least one staff member has taken an interest in my
development
I feel valued at this institution
Faculty believe in my potential to succeed
academically
My college experiences have exposed me to diverse
opinions, cultures, and values

Please indicate the extent to which you agree or disagree with the following statements:
(Mark one in each row)

Agree

Strongly

Staff encouraged me to get involved in campus activities
In class, I have heard faculty express stereotypes based
on race/ethnicity, gender, sexual orientation, or
religious affiliation
Staff recognize my achievements
Faculty encouraged me to meet with them outside of
class
I am interested in seeking information about current
social and political issues
I feel a sense of belonging to this campus
At least one faculty member has taken an interest in my
development
I feel I am a member of this college
I have effectively led a group to a common purpose
It's important for me to be thinking about my career
path after college

What is your overall grade average (as of your most recently completed academic term)?
A or A+
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AB+
B
BC+
C
D
I did not receive grades in my courses

Please rate your satisfaction with this institution on each of the aspects of college life
listed below.
(Mark one in each row)

Rate/No
Satisfied Satisfied Neutral Dissatisfied Dissatisfied Experience
Amount of contact with faculty
Racial/ethnic diversity of faculty
Racial/ethnic diversity of student
body
Class size
Interaction with other students
Relevance of coursework to everyday
life
Relevance of coursework to future
career plans
Overall quality of instruction
Respect for the expression of diverse
beliefs
Availability of campus social activities
Your social life
Overall sense of community among
students
Overall college experience
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Please rate your agreement with the following statements: This institution has
contributed to my:
(Mark one in each row)

Agree

Strongly

Intellectual and practical skills (including
inquiry and analysis, critical thinking, and
information literacy)
Knowledge of a particular field or discipline
Knowledge of people from different
races/cultures

Understanding of the problems facing your
community
Understanding of national issues
Understanding of global issues
Ability to conduct research
Ability to work as part of a team
Critical thinking skills
Problem-solving skills
Foreign language ability

To what extent have you experienced the following with students from a racial/ethnic
group other than your own?
(Mark one in each row)
Very

Never

Dined or shared a meal
Had meaningful and honest discussions
about race/ethnic relations outside of class
Had guarded, cautious interactions
Shared personal feelings and problems
Had tense, somewhat hostile interactions
Had intellectual discussions outside of
class
Felt insulted or threatened because of your
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race/ethnicity

Studied or prepared for class
Socialized or partied

Where did you primarily live while attending college this past year?
Special Interest On Campus Housing
First-year student housing
Cultural or minority student housing
Single-sex housing
Special academic program housing
Other special interest housing
Regular On Campus College Housing
Residence hall
Apartment
Fraternity or sorority housing
Other residential housing
Off Campus
At home with family
Fraternity or sorority
Rented apartment or house
Other

Indicate the importance to you personally of each of the following:
(Mark one in each row)
Very

Not

Essential
Becoming accomplished in one of the performing
arts (acting, dancing, etc.)
Obtaining recognition from my colleagues for
contributions to my special field
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Influencing the political structure

Influencing social values
Raising a family
Being very well off financially
Helping others who are in difficulty
Making a theoretical contribution to science
Writing original works (poems, novels, etc.)

Indicate the importance to you personally of each of the following:
(Mark one in each row)

Essential

Very

Not

Creating artistic works (painting, sculpture, etc.)
Developing a meaningful philosophy of life
Participating in a community action program
Helping to promote racial understanding

Keeping up to date with political affairs
Becoming a community leader
Improving my understanding of other countries
and cultures

Since entering this college have you:
(Mark yes or no for each item)

Decided to pursue a different major
Remained undecided about a major
Failed one or more courses
Taken an honors course
Taken a remedial or developmental course
Enrolled in a formal program where a group of students takes
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two or more courses together (e.g., FIG, learning community,
linked courses)
Participated in an academic support program
Taken a course or first-year seminar designed to:
Connect faculty and students in focused academic inquiry
Help students adjust to college-level academics
Help students adjust to college life
Communicated regularly with your professors
Taken courses from more than one institution simultaneously
Taken a course exclusively online:

At this institution
At a different institution

Since entering this college have you:
(Mark yes or no for each item)

Changed your career choice

Held a full-time job (approx. 40 hours) while taking
classes
Joined a social fraternity or sorority
Played club, intramural, or recreational sports
Played intercollegiate athletics (e.g., NCAA or NAIAsponsored)
Sought personal counseling
Strengthened your religious beliefs/convictions
Had a roommate of a different race/ethnicity

Accumulated excessive credit card debt
Been a leader in an organization
Voted in a national, state, or local election
Participated in:
Student government
Leadership training
An ethnic/racial student organization
An LGBTQ student organization
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Since entering this college, how much time have you spent during a typical week doing
the following activities?
(Mark one for each item)
Less
than 1

1-2 hrs

3-5 hrs

6-10
hrs

hrs

Over 20
hrs

Attending classes/labs
Studying/homework
Socializing with friends in
person
Exercising or sports
Partying
Working (for pay) on campus
Working (for pay) off campus
Student clubs and groups

Household/childcare duties
Commuting
Online social networks

Since entering this college, indicate how often you:
(Mark one for each item)
Not at all
Turned in course assignment(s) late
Contributed to class discussions
Discussed course content with students outside of class
Skipped class
Received tutoring
Worked on a professor's research project
Turned in course assignments that did not reflect your best
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work

Had difficulty getting along with your
roommate(s)/housemate(s)
Received from your professor advice or guidance about
your educational program
Witnessed academic dishonesty/cheating

Since entering this college, indicate how often you:
(Mark one for each item)
Not at all
Went home for the weekend
Received advice/counseling from another student
Fell asleep in class
Had difficulty getting the courses you need
Instant messaged/texted during class
Worked with classmates on group projects:
During class

Outside of class
Accessed your campus' library resources electronically
Made a presentation in class
Used the institution's course catalog (paper or online)

How would you characterize your political views?
Far left
Liberal
Middle-of-the-road
Conservative
Far right

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Are you currently registered to vote?
Ineligible
Yes
No

If you could make your college choice over, would you still choose to enroll at your
current (or most recent) college?
Definitely yes
Probably yes
Probably not
Definitely not
Not sure yet

Since entering this college, how often have you utilized the following services:
(Mark one in each row)
Not at all
Study skills advising
Financial aid advising
Student health services
Student psychological services
Writing center
Disability resource center
Career services
Academic advising

What do you think you will be doing in fall 2016?
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Attending your current (or most recent) institution
Attending another institution
Don't know/have not decided yet
Not attending any institution

Do you plan to do any of the following this summer?
(Mark one in each row)

Take courses at this institution
Take courses at another institution
Work for pay
Participate in an internship
Travel

Did you transfer into this institution from another college/university?
Yes
No

Is English your native language?
Yes
No

Additional Questions
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