Form 5 BUILD Student Annual Followup Survey

Attachment 12 (revised 03.10.17):

BUILD Student Annual Follow-up Survey

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You have been selected to be a part of a national study on student experiences. Your school is part of the Diversity Program Consortium, a
national effort funded by the National Institutes of Health to improve the educational and career success of students and faculty. By taking

time to complete this survey, you will help increase knowledge and improve education for the next generation of students.
The University of California, Los Angeles (UCLA) serves as the coordinating center of this national effort and is in charge of collecting
information about the experiences and career choices of a variety of students. It will be important to compare students at your school to those
at other institutions.
Your school has provided UCLA your name and contact information. You may have previously contributed to this effort by completing one of

the national student surveys offered at your institution this past academic year. By taking this survey, you are giving permission for your
school to share information from your student record such as demographics, the courses you take, and the grades you receive in your courses
with the UCLA team. You are also giving the UCLA team permission to share the information you provide with your institution for research
purposes and to contact you every year or so for follow-up surveys to understand your career choices after you leave your school. Only with the

continued participation and support of students such as yourself will we be able to show the value of the various programs offered through
your institution to help students such as yourself succeed. All of the information you provide will be protected and secured to the extent
permitted by law.

In this survey, we will ask you about publications and grants. You have the option to upload a document that includes such information
(such as a resume) instead of entering this information directly for each publication or grant in the survey.
Public reporting burden for this collection of information is estimated to average 25 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. 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
(0925-0747*). Do not return the completed form to this address.

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First, we would like to ask you about any current school or work activities.

Are you still in school?

No
Yes
I choose not to answer

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Expected completion date for degree program (year):

Full Time

Status:

Part Time
I choose not to answer

Institution:

(Select One...)

Major:

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4

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Please tell us your current status

I graduated from my previous institution
I did not graduate but do have plans to attend school in the next 2 years
I did not graduate and do NOT have plans to attend school in the next 2
years
I choose not to answer

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Now we would like to ask you about any employment or internships. Are
you currently working (for pay), interning, or volunteering?

No
Yes
I choose not to answer

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Please describe any work, internship, or volunteering (check all that apply):

Full Time
Part Time
Internship or student placement
Seasonal (full-time or part-time)
Volunteer, unpaid internship, or other unpaid position

Please briefly describe your paid position(s):
Position:

Company/Institution:

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Is this paid position related to research?

No
Yes

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Please briefly describe your volunteer position(s):
Position:

Company/Institution:

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Is this volunteer position related to research?

No
Yes

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During the past year, did you complete any degree or certificate program?
Certificate programs are those that require completion of multiple units
over extended months or years. Do not include one-time workshops.

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No
Yes
I choose not to answer

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Completed degree(s) or certificate program(s)

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During the past year, did you apply to any degree or certificate program?
Certificate programs are those that require completion of multiple units
over extended months or years. Do not include one-time workshops.

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No
Yes
I choose not to answer

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Applied degree(s) or certificate program(s)

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During the past year, did you receive any scholarships or grants for
education expenses that you do not need to repay?

No
Yes
I choose not to answer

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Describe any scholarships or grants received

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Do you have any education debt?

No
Yes
I choose not to answer

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Total amount that you owe:

$
I don't know how much I owe

How much you borrowed during the past year:

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$

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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)
I choose not to answer

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Please tell us which of the following activities you participated in during
summer 2016 or the 2016-17 school year. Check all that apply.

Tuition or stipend program
Summer program (e.g., Summer Research Experience)
Academic advising and support beyond that provided to all students at
your institution (e.g., specialized tutoring, STEM advising)
Mentoring (A mentor provides guidance, assistance, and encouragement
on professional and academic issues.)
Research training (e.g., workshops, training, field experience, conferences,
etc.)
Career advancement programs (e.g., networking, professional exposure,
GRE Prep, field trips, career panels, applications)

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In the past year, have you participated in a pre-professional or
departmental club?

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No
Yes

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To allow us to follow your professional accomplishments, please provide any of the following identifiers that you may have:

LinkedIn ID:
I do not have one

ORCID ID:
I do not have one

NIH eRA Commons ID:
I do not have one

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This next section concerns your experiences with mentoring in a variety of contexts.
A mentor is someone who provides guidance, assistance, and encouragement on professional and academic issues. A mentor can be
either someone who is more experienced (or senior) than you or someone who is at an education or professional level similar to you (a
"peer").
A mentee is someone who receives guidance or assistance from a mentor. A mentee can be someone less experienced (or junior) than you
or someone who is your peer.
A mentoring relationship can be formal (with a set schedule and perhaps arranged by your institution) or informal.

First, we would like to ask you about a mentor who is senior to you. Do you
have a faculty member or someone else who is more senior than you
whom you consider a mentor ?

No
Yes
I choose not to answer

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How many different mentors do you regularly work with?

For the mentor you work with most closely (your primary mentor), please provide the following information:
Position:

Institution/ Company:

Discipline:

Which of the following does your primary mentor help you with? (Please
choose all that apply.)

Research in general (e.g., guidance related to finding literature, research
techniques, and selecting a research topic)
Specialized research issues (e.g., just on statistics or instrumentation)
Educational choices and strategies (e.g., guidance in selecting
coursework, further educational opportunities)
Career planning (e.g., giving advice, helping find opportunities)
Emotional support (e.g., listening to personal concerns)
Other (specify):

How do you usually communicate with your primary mentor?

In-person
Phone/Skype
Email/Text
Other (specify):

How often do you usually communicate with your primary mentor about
your research?

Weekly or more often
Monthly
Several time a year
Annually or less

How did you find this mentor? (Note: Your local BUILD program is called
local campus name )

Through your local BUILD
They were assigned in some other way by your department or campus
You were matched / linked through the National Research Mentoring
Network (NRMN)
Matched / linked through some other formal program
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You sought out your mentor independently
Other (specify):

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Please rate how skilled you feel your primary mentor was in the following areas:

Active listening

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Providing constructive feedback

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Establishing a relationship based

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

on trust

Identifying and accommodating
different communication styles

Employing strategies to improve
communication

Coordinating effectively with
other mentors with whom you
work

Working with you to set clear
expectations of the mentoring
relationship

Aligning his/her expectations with
your own

Considering how personal and
professional differences may
impact expectations

Working with you to set research
goals

Helping you develop strategies to
meet goals

Accurately estimating your level
of scientific knowledge

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Accurately estimating your ability

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

to conduct research

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Please rate how skilled you feel your primary mentor was in the following areas:

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Motivating you

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Building your confidence

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Stimulating your creativity

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Acknowledging your professional

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Helping you network effectively

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Helping you set career goals

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Helping you balance work with

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Employing strategies to enhance
your understanding of the
research

contributions

Negotiating a path to professional
independence with you

Taking into account the biases
and prejudices s/he brings to
your mentor/mentee relationship

Working effectively with mentees
whose personal background is
different from his/her own (age,
race, gender, class, region,
culture, religion, family
composition, etc.)

your personal life

Understanding his/her impact as
a role model for you

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Helping you acquire resources

Back

1 - Not at all

Next

2

3

4

5

6

7 - Extremely

N/A

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In your mentoring relationship, how important is it to you that your primary mentor does the following:

Is willing to discuss diversity:

Not Important
Somewhat Important
Very Important
N/A

Considers their own cultural background, as well as yours:

Not Important
Somewhat Important
Very Important
N/A

Values and respects cultural differences:

Not Important
Somewhat Important
Very Important
N/A

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In your mentoring relationship, how skilled is your primary mentor in the following:

Discussing diversity:

Not Skilled
Somewhat Skilled
Very Skilled
N/A

Considering their own cultural background, as well as yours:

Not Skilled
Somewhat Skilled
Very Skilled
N/A

Valuing and respecting cultural differences:

Not Skilled
Somewhat Skilled
Very Skilled
N/A

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How would you rate the overall

1 - Very Low

2

3

4 - Average

5

6

7 - Very High

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Very Low

2

3

4 - Average

5

6

7 - Very High

N/A

quality of the mentoring you
received from your primary
mentor?

How satisfied are you with the
mentoring you are receiving from
your primary mentor?

To what extent do you feel your
primary mentor is meeting your
expectations?

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In addition to having mentors who are senior to themselves, many people also have mentors that are at a similar educational or
professional level as themselves (a peer). For the next set of items, please consider any of your peer mentors.

Do you have someone at a similar educational level as you (i.e., a peer)
who you consider an academic/career mentor?

No
Yes
I choose not to answer

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How many different peer mentors do you have?

Which of the following do your peer mentors help you with? (Choose all
that apply)

Research issues
Social and emotional needs (e.g., sharing concerns about schools)
Tangible help (e.g., advice about faculty and classes, help with writing)
Networking assistance (e.g., helping you meet other people in your field)
Career planning (e.g., giving advice, helping find opportunities)
Other (specify):

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Now we would like to ask you about any mentoring that you do. This first set of items asks about mentoring YOU may do with those you are
JUNIOR to you.

Do you have anyone who you currently mentor about academic issues
who is junior to you ?

No
Yes
I choose not to answer

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How many different people do you regularly mentor currently?

At what education level are the people you mentor? (Choose all that apply)

College students
High school students
Middle or elementary school students

Which of the following do help your mentees with? (Choose all that apply)

Research issues
Social and emotional needs (e.g., sharing concerns about schools)
Tangible help (e.g., advice about faculty and classes, help with writing)
Networking assistance (e.g., helping them meet other people in your
field) Career planning (e.g., giving advice, helping find opportunities)
Other (specify):

How do you communicate with your mentees?

In-person
Phone/Skype
Email/Text
Other (specify):

On average, how often do you usually communicate with your mentees?

Weekly or more often
Monthly
Several times a year
Annually or less

How did you first connect with your mentees? (Choose all that apply)
Note: Your local BUILD program is called local campus name

Through your local BUILD program
They were assigned in some other way by your department or campus
Matched / linked through some other formal program
They sought you out independently
Other (specify):

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Please rate how skilled you feel you are in each of the following areas when mentoring those junior to you:

Active listening

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Providing constructive feedback

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Establishing a relationship based

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

on trust

Identifying and accommodating
different communication styles

Employing strategies to improve
communication with mentees

Coordinating effectively with your
mentees’ other mentors

Working with mentees to set clear
expectations of the mentoring
relationship

Aligning your expectations with
your mentees’

Considering how personal and
professional differences may
impact expectations

Working with mentees to set
research goals

Helping mentees develop
strategies to meet goals

Accurately estimating your
mentees’ level of scientific
knowledge

41

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Motivating your mentees

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Building your mentees’ confidence

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Stimulating your mentees’

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

Accurately estimating your
mentees’ ability to conduct
research

Employing strategies to enhance
your mentees’ knowledge and
abilities

creativity

Acknowledging your mentees’
professional contributions

Negotiating a path to professional
independence with your mentees

Taking into account the biases
and prejudices you bring to the
mentor/mentee relationship

Working effectively with mentees
whose personal background is
different from your own (age,
race, gender, class, region,
culture, religion, family
composition, etc.)

Helping your mentees network
effectively

Helping your mentees set career
goals

Helping your mentees balance
work with their personal life

Understanding your impact as a
role model before their research
experience

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Helping your mentees acquire

1 - Not at all

2

3

4

5

6

7 - Extremely

N/A

resources

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In your mentoring relationship, how important is it to you that YOU do the following:
Be willing to discuss diversity issues

Not Important
Somewhat Important
Very Important
N/A

Consider your mentees' cultural background and your own

Not Important
Somewhat Important
Very Important
N/A

Value and respect cultural differences

Not Important
Somewhat Important
Very Important
N/A

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In your mentoring relationship, how skilled are YOU in the following:
Discussing diversity

Not Skilled
Somewhat Skilled
Very Skilled
N/A

Considering your mentees' cultural background, as well as yours

Not Skilled
Somewhat Skilled
Very Skilled
N/A

Valuing and respecting cultural differences

Not Skilled
Somewhat Skilled
Very Skilled
N/A

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How satisfied are you with the

1 Not at all

2

3

4

5

6

7 Extremely

N/A

mentoring you are providing to
your mentees?

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These next items focus on people you mentor who are peers to you (at a similar educational and professional level). For the next set of
items, please consider your peer mentees.

Do you have anyone who you currently mentor on academic/career issues
who is at a similar level to yours (a peer)?

No
Yes
I choose not to answer

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How many different people do you regularly mentor currently?

Which of the following do you help your mentees with? (Choose all that
apply)

Research issues
Social and emotional needs (e.g., sharing concerns about schools)
Tangible help (e.g., advice about faculty and classes, help with writing)
Networking assistance (e.g., helping you meet other people in your field)
Career planning (e.g., giving advice, helping find opportunities)
Other (specify):

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Indicate the importance to you personally of each of the following:

Obtaining recognition from

Essential

Very Important

Somewhat Important

Not Important

N/A

Essential

Very Important

Somewhat Important

Not Important

N/A

Essential

Very Important

Somewhat Important

Not Important

N/A

colleagues for contributions to
my special field.

Making a theoretical contribution
to science.

Becoming an authority in my
field.

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Indicate to what extent the following statements are true of you:

I have strong sense of belonging

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

N/A

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

N/A

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

N/A

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

N/A

to the community of scientists.

I derive great personal
satisfaction from working on a
team that is doing important
research.

I have come to think of myself as
a 'scientist'.

I feel like I belong in the field of
science.

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Indicate to what extent you are confident that you can complete the following tasks:

Use technical science skills (use of tools, instruments, and/or techniques)
Absolutely confident

Very confident

Somewhat confident

A little confident

Not at all confident

N/A

Somewhat confident

A little confident

Not at all confident

N/A

Very confident

Somewhat confident

A little confident

Not at all confident

N/A

Very confident

Somewhat confident

A little confident

Not at all confident

N/A

Somewhat confident

A little confident

Not at all confident

N/A

Somewhat confident

A little confident

Not at all confident

N/A

Generate a research question
Absolutely confident

Very confident

Determine how to collect appropriate data
Absolutely confident

Explain the results of a study
Absolutely confident

Use scientific literature to guide research
Absolutely confident

Very confident

Integrate results from multiple studies
Absolutely confident

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Very confident

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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.

Academic ability

Highest 10%

Above Average

Average

Below Average

Lowest 10%

N/A

Drive to achieve

Highest 10%

Above Average

Average

Below Average

Lowest 10%

N/A

Mathematical ability

Highest 10%

Above Average

Average

Below Average

Lowest 10%

N/A

Self-confidence (intellectual)

Highest 10%

Above Average

Average

Below Average

Lowest 10%

N/A

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Will you pursue a science-related research career?

Definitely yes
Possibly yes
Uncertain
Possibly no
Definitely no
I choose not to answer

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Frequently

Occasionally

Not at all

N/A

Tutored another student

Frequently

Occasionally

Not at all

N/A

Discussed course content with students outside of class

Frequently

Occasionally

Not at all

N/A

Received advice/counseling from another student

Frequently

Occasionally

Not at all

N/A

Worked with classmates on group projects

Frequently

Occasionally

Not at all

N/A

How often have you studied with other students?

Since entering this college, indicate how often you:

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During the past year (Summer 2016 or this academic year (2016-17)), have
you participated in any training to improve your skills as a mentor or as a
mentee?

No
Yes
I choose not to answer

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Type of training (Select all that apply)

In-person
On-line that occurs in scheduled, real-time (synchronous)
On-line or other virtual that you can take at any time that provides
feedback or interaction with others (asynchronous)
Self-study (by any means, but no interaction or feedback)

Approximately how many hours was your training over the past year?

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hours

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Have you completed formal training/workshops related to your career or
research (minimum of at least 4 hours duration)?

No
Yes
I choose not to answer

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Please indicate the focus of the training:

On NIH funding?

No
Yes

On other funding?

No
Yes

On biomedical career development (e.g., training in leadership, teaching,
mentoring, publishing, gaining tenure, etc.)?

On other biomedical research related topics?

No
Yes

No
Yes

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The next set of items ask about grants and publications. If you have a
document that lists these (such as a resume or CV), you can upload that
document and skip some of the items below. Otherwise, we will ask you to
provide information about each grant and publication.

No
Yes
I choose not to answer

Do you have a resume or CV to upload?

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Now we would like to know about your publications and grants. If you have
a document (such as a CV)

Choose File

no file selected

Defer for now
I do not want to upload my CV

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Have you had any opportunity to conduct your own scientific research or
to participate in scientific research directed by others in the past year?

No
Yes
I choose not to answer

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Please check all research activities you participated in last year (Choose all
that apply)

Hands-on research activities with laboratory equipment in a class
Worked in a laboratory in a college/university
Worked on research in a non-academic location
Designed your own research experience
Literature review, synthesis of existing knowledge, and/or conceptual
Analysis of existing (secondary) data
Analysis of data you collect (primary analysis)
None of the above
Other (specify):

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For each item you checked on the previous page, please indicate the following:

Hands-on research activities with laboratory equipment in a class:
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

Hands-on research activities with laboratory equipment in a class:
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

Worked in a laboratory in a college/university:
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

Worked in a laboratory in a college/university:
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

Worked on research in a non-academic location:
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

Worked on research in a non-academic location:
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

Designed your own research experience:
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

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Designed your own research experience:
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

Literature review, synthesis of existing knowledge, and/or conceptual:
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

Literature review, synthesis of existing knowledge, and/or conceptual:
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

Analysis of existing (secondary) data:
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

Analysis of existing (secondary) data:
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

Analysis of data you collect (primary analysis):
What was the research for?

A class or degree requirement
Part of a paid job (e.g., research assistant), internship, or training program)
Related to your role as an independent researcher

Analysis of data you collect (primary analysis):
What was your role?

Project Lead on my own project
Working on someone else‘s student-led project
Working on a faculty member-led project
Other (specify):

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Since you started college, have you applied for or received funding to
support your own research? Please do not include fellowships or
scholarships that primarily pay for tuition, fees, or living expenses. Also,
please do not include service projects unless they include a research

No
Yes
I choose not to answer

component.

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Please complete or update information for each grant or proposal:
Please check here if you want us to refer to your CV.

Listing of Grants and Proposals

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Add a Grant or Proposal

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The next set of items ask about publications. If you have a list of these and
did not upload already, you can upload it now.
Do you have any scientific publications accepted, in-press, or published
(including as a co-author)?

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No
Yes
I choose not to answer

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Publication Type:

Journal article
Chapter in a book
Book
Other - Please provide a citation of your publication:

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Please check here if you want us to refer to your CV.

Journal Article

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Add Journal Article

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Please check here if you want us to refer to your CV.

Publications to Chapters/Books

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Have you presented at a scientific conference in the last year (including
posters)?

No
Yes
I choose not to answer

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Have your received any honors or awards this past year?

No
Yes

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Please provide the name/title of the honors or awards you've received:

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Have you held office in any pre-professional or professional organization in
the past year?

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No
Yes

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Please list any offices you have held in pre-professional or professional
organizations in the past year:

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Since entering this college, how often have you interacted with the following people (e.g., by phone, e-mail, text, or in person):

Faculty during office hours
Daily

2 or 3 more times per week

Once a week

1 or 2 times per month

1 of 2 times per term

Never

N/A

Once a week

1 or 2 times per month

1 of 2 times per term

Never

N/A

Once a week

1 or 2 times per month

1 of 2 times per term

Never

N/A

Once a week

1 or 2 times per month

1 of 2 times per term

Never

N/A

Faculty outside of class or office hours
Daily

2 or 3 more times per week

Academic advisors/counselors
Daily

2 or 3 more times per week

Graduate students/teaching assistants
Daily

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2 or 3 more times per week

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Since entering this college, how often have you felt:

Lonely or homesick

Frequently

Occasionally

Not at all

N/A

Isolated from campus life

Frequently

Occasionally

Not at all

N/A

Unsafe on this campus

Frequently

Occasionally

Not at all

N/A

Worried about your health

Frequently

Occasionally

Not at all

N/A

That your courses inspired you to think in new ways

Frequently

Occasionally

Not at all

N/A

That your job responsibilities interfered with your schoolwork

Frequently

Occasionally

Not at all

N/A

That your family responsibilities interfered with your schoolwork

Frequently

Occasionally

Not at all

N/A

Family support to succeed

Frequently

Occasionally

Not at all

N/A

That faculty provided me with feedback that helped me assess my

Frequently

Occasionally

Not at all

N/A

That my contributions were valued in class

Frequently

Occasionally

Not at all

N/A

That faculty encouraged me to ask questions and participate in

Frequently

Occasionally

Not at all

N/A

progress in class

discussions

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Since entering this college, how has it been to:

Understand what your professors expect of you academically

Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult

N/A

Develop effective study skills

Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult

N/A

Adjust to the academic demands of college

Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult

N/A

Manage your time effectively

Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult

N/A

Develop close friendships with other students

Very Easy

Somewhat Easy

Somewhat Difficult

Very Difficult

N/A

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Please indicate the extent to which you agree or disagree with the following statements:

I see myself as part of the campus community

Strongly Agree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

N/A

Faculty showed concern about my progress

Strongly Agree
N/A

I have been able to find a balance between academics and extracurricular
activities

Faculty empower me to learn here

Strongly Agree
N/A

Strongly Agree
N/A

If asked, I would recommend this college to others

Strongly Agree
N/A

I feel valued at this institution

Strongly Agree
N/A

Faculty believe in my potential to succeed academically

Strongly Agree
N/A

My college experiences have exposed me to diverse opinions, cultures,
and values

Faculty encouraged me to meet with them outside of class

Strongly Agree
N/A

Strongly Agree
N/A

I feel a sense of belonging to this campus

Strongly Agree
N/A

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At least one faculty member has taken an interest in my development

Strongly Agree

Agree

Disgree

Strongly Disagree

Agree

Disgree

Strongly Disagree

N/A

I feel I am a member of this college

Strongly Agree
N/A

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Please rate your satisfaction with your college in each area:

Amount of contact with faculty
Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied

Can‘t Rate / No Experience

N/A

Dissatisfied

Very Dissatisfied

Can‘t Rate / No Experience

N/A

Dissatisfied

Very Dissatisfied

Can‘t Rate / No Experience

N/A

Ability to find a faculty or staff mentor
Very Satisfied

Satisfied

Neutral

Overall sense of community among students
Very Satisfied

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Satisfied

Neutral

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Finally, we just need a bit of information about you.
Please indicate “Yes” or “No” for each of the following:

Are you deaf or do you have a serious difficulty hearing?

No
Yes

Are you blind or do you have serious difficulty seeing, even when wearing
glasses?

No
Yes

Because of a physical, mental, or emotional condition, do you have serious
difficulty concentrating, remembering, or making decisions?

Do you have serious difficulty walking or climbing stairs?

No
Yes

No
Yes

Do you have difficulty dressing or bathing?

No
Yes

Because of a physical, mental, or emotional condition, do you have
difficulty doing errands alone such as visiting a doctor's office or shopping?

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No
Yes

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Are you Hispanic, Latino/a, or Spanish origin?

No
Yes

What is your race? Check all that apply.

White
Black or African American
American Indian or Alaska Native
Asian Indian
Chinese
Filipino
Japanese
Vietnamese
Other Asian
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander

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You deferred earlier in the survey to upload a CV. We are giving you
another opportunity to upload a document (such as a CV) that lists your

Choose File

no file selected

grants and publications.
I do not want to upload my CV

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87