FSA Research Participant Recruiting Questionnaire w burden statement

Federal Student Aid User Experience Design Research Generic Clearance

FSA Research Participant Recruiting Questionnaire w burden statement

OMB: 1845-0159

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Federal Student Aid

Digital & Customer Care Platform & Services Design Research Screener Question Pool

OMB Control Number: 1845-0159


Demographic questions

First name

[text entry]


Last name

[text entry]


Email

[text entry]


Phone number

[number entry]


State or territory of residence

[text entry]


Age group

  • Under 18

  • 18-24 years old

  • 25-34 years old

  • 35-44 years old

  • 45-54 years old

  • 55-64 years old

  • 65-74 years old

  • 75 years or older


Can you claim anyone as a dependent?

  • Yes

  • No


What is your dependent’s education level(s)? (Check all that apply)

  • Less than High School

  • High School or GED

  • Vocational or other

  • Some college, no degree

  • Associate degree

  • Bachelor’s degree

  • Other: [text entry]


Are you currently in the armed forces?

  • Yes

  • No


Have you ever served in the military?

  • Yes

  • No


Are you of Hispanic or Latino descent?

  • Yes

  • No


What race do you most identify with? (Check all that apply)

  • Native American or Alaska Native

  • Asian

  • Black or African American

  • Native Hawaiian or Other Pacific Islander

  • White

  • Prefer not to answer


What is your parents’ education level?

  • Neither parent completed college

  • One parent completed college

  • Both parents completed college


What is your marital status?

  • Single

  • Married

  • Divorced

  • Other: [text entry]

  • Prefer not to answer


How would you rate your fluency in English?

  • Native

  • Fluent

  • Conversational

  • Beginner

  • I don’t speak English


Would you consider yourself an English learner?

  • Yes

  • No


Would you or anyone in your family consider themselves an English learner?

  • Yes

  • No


How would you rate your fluency in Spanish?

  • Native

  • Fluent

  • Conversational

  • Beginner

  • I don’t speak Spanish


Are you a native or fluent speaker of any other languages? If so, please specify.

[text entry]


What is your household income?

  • $0 - 25,000

  • $26,000- $50,000

  • $51,000 - $75,000

  • $76,000 - $125,000

  • $126,000 - $150,000

  • $150,000+

  • Don’t know/Not sure

  • Prefer not to answer




Education

What is the highest level of education you have completed?

  • Some high school

  • High school graduate

  • Professional or career school

  • Some college

  • Associate’s degree

  • Bachelor’s degree

  • Some graduate school

  • Master’s degree

  • Doctoral degree


What best describes your current situation in regard to college or career school?

  • I attend in-person

  • I am an online student

  • I attend both online and in-person

  • I deferred my acceptance

  • I took a leave of absence

  • I withdrew

  • I graduated

  • I will be attending school

  • I don’t plan to attend school

  • Other: [text entry]


Are you a first-generation college student?

  • Yes

  • No

  • Don’t know/Not sure


What is your current enrolment status?

  • Part time

  • Full time


What degree are you pursuing?

  • Certificate

  • Associate’s degree

  • Bachelor’s degree

  • Master’s degree

  • Doctoral degree

  • Undecided


When did you graduate from your most recent schooling?

  • 0–5 months ago

  • 6–12 months ago

  • 1–2 years ago

  • 2-5 years ago

  • 5+ years ago

  • I’m currently in school

  • Don’t know/Not sure


Do you have any dependents currently enrolled in a post-secondary school (college or career school)?

  • Yes

  • No


What type of college or career school is/are your dependent(s) attending? (check all that apply)

  • Two-year Public

  • Four-year Public

  • Two-year Private

  • Four-year Private

  • Proprietary

  • Vocational



Federal Student Aid: Student Loans and grants

Have you received financial aid from the federal government to help pay for school? (Check all that apply)

  • Direct subsidized loan

  • Direct unsubsidized loan

  • Direct Parent PLUS loan

  • Direct Grad PLUS loan

  • Federal Perkins loan

  • Federal Family Education Loan (FFEL)

  • Direct Consolidated loan

  • Pell Grant

  • ISAG Grant

  • FSEOG Grant

  • TEACH Grant

  • Work-study program

  • I have not received any financial aid from the federal government

  • Don’t know/Not sure


How much federal student loan debt do you have?

  • < $10,000

  • $10,001–$25,000

  • $25,001–$75,000

  • $75,001–$100,000

  • $100,000+

  • Prefer not to say

  • Don’t know/Not sure


Have you started paying back your loans?

  • Yes

  • No

  • Don’t know/Not sure


Which of the following best describes your situation in regard to making payments on your student loans?

  • I am in a grace period

  • I am making payments on time

  • I am behind on my payments

  • My loans are in default

  • My loans are in deferment or forbearance

  • I completed my payments

  • Other: [text entry]


What repayment plan are you on?

  • Standard Repayment Plan

  • Graduated Repayment Plan

  • Extended Repayment Plan

  • Income-driven Repayment Plan

  • Don’t know/Unsure

Which Income-Driven Repayment Plan are you on?

  • Revised Pay As You Earn Repayment Plan (REPAYE)

  • Pay As You Earn Repayment Plan (PAYE)

  • Income-Based Repayment Plan (IBR)

  • Income-Contingent Repayment Plan (ICR)

  • Income-Sensitive Repayment Plan

  • Don’t know/Not sure

Have you ever defaulted on your federal student loans?

  • Yes

  • No

  • Don’t know/Unsure


Are any of your current student loans in delinquent status or have defaulted?

  • Yes

  • No

  • Don’t know/Unsure


Have you ever participated in a user research activity, market research discussion group, or individual interview with the Department of Education or Federal Student Aid before?

  • Yes

  • No


When was the last time you participated in a user research activity, market research discussion group, or individual interview?

  • Within the past three months

  • 3-12 months

  • Over a year ago


Employment

Which of the following best describes your current employment situation?

  • Employed full time

  • Employed part time

  • Not employed, seeking work

  • Not employed, not seeking work


What is your current job?

[text entry]


Which of the following best describes your employer?

  • Government organizations (federal, state, local, or tribe)

  • Not-for-profit organizations

  • Private business

  • Other: [text entry]

  • Don’t know/Not sure


Do your work for an institution of higher education?

  • Yes

  • No


Do you work at a college financial aid office?

  • Yes

  • No


What is your job within your college’s financial aid office?

[text entry]


Do you work in a nonprofit that focuses on higher education?

  • Yes

  • No


Do you work at a secondary school (high school)?

  • Yes

  • No


Are you a secondary school (high school) counselor?

  • Yes

  • No


Are you a post-secondary school (college) counselor?

  • Yes

  • No



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