Former Postsecondary Student Protocol Intro Questionnair

CFPB RDHE – Former Postsecondary Student Protocol

Intro Questionnaire

OMB Control Number: 3170-0036
Expiration Date: XX/XX/XXXX

Paperwork Reduction Act Statement

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor a collection of information, nor is a person required to respond to a collection of information unless it displays a valid OMB control number.  The time burden required to complete this collection of information is estimated to be 5 minutes per response.  Comments regarding this collection of information (e.g comments regarding the time burden per response, suggestions for reducing the time burden per response, and/or suggestions for maximizing the utility of the collected information) should be submitted to the Consumer Financial Protection Bureau at [email protected].

Privacy Notice

The information you provide to ICF International (ICF) will be used to further inform the ICF project team about the participant pool for the Racial Disparities in Higher Education focus groups and interviews sponsored by the Consumer Financial Protection Bureau (CFPB).

The survey is anonymous and no personally identifiable information (PII) will be collected or shared with the CFPB.

Participation is voluntary.

Where did you grow up? ___________________________________________

Where do you live now? ___________________________________________

How many different colleges have you been enrolled in? __________

What years were you enrolled in college? _________________ to ______________________

Repeat if enrolled at different times: _________________ to __________________

Repeat if enrolled at different times: _________________ to __________________

Repeat if enrolled at different times: _________________ to __________________

What was your major or program of study? ____________________________________________

Did you complete a degree?

• Yes

• No

Regardless of whether you completed degree or not, do you plan on reenrolling in college?

• Yes

• No

Are you currently employed?

• Yes

• No

If currently employed, please list your job title or describe your role:

__________________________________________________