STEIN ACADEMY ONLINE SURVEY of GRADUATES
PERSONAL INFORMATION
1. Please print your name, a permanent address and telephone number that we may use to contact you in the future.
* First Name:
* Last Name:
* Street:
* City:
* State:
* Zip Code:
* Telephone Number:
(e.g .(000) 000-0000 )
* Country:
2. * Name of Program you graduated in:
3. * Who was your instructor?
4. What is your gender?
Male
Female
5. What is your age?
6. What is your marital Status?
Single
Married
Other
EXTERNSHIPS OR CLINICAL RLATED TO YOUR PROGRAM (IF ANY)
7. If you completed a Clinical or Externship as part of your program, tell us where you did it.
7.a Name of Clinical or Externship Site:
7.b Location/Address:
8. How did you obtain the Clinical or Externship described above?
8.a I found the Clinical/Externship by myself
8.b I used the services of Stein Academy Placement & Career Development Center
8.c Other (Please specify):
EMPLOYMENT
9. Are you currently employed or have you secured a full time employment which you plan to begin after graduation from Stein Academy? If yes please provide the information below.
9.a Name of Employer
9.b Address of Employer
9.c Job Title or Position
9.d How long have you worked with this company/organization?
9.e Date you were hired or Date you started Work:
9.f Are you employed Full Time or Part Time?
9.g How much do you make an hour or in a year (You can approximate the amount)
9.h Your Work or Employer’s Phone Number
9.i Name of your Immediate Supervisor
10. How did you obtain the job(s) described above?
10.a I found the Clinical/Externship by myself
10.b I used the services of Stein Academy Placement & Career Development Center
10.c Other (Please specify):
11. Have you used the services of Stein Academy Placement & Career Development Office to find permanent job after graduation?
Yes
No
11.a If yes, how many interviews or referrals have you had through that office:
12. On a scale of 1 to 5 please evaluate the following
Note: 1=poor, 2=fair, 3=average, 4=above average, 5=excellent
12.a Quality of course work/course/program you pursued at Stein Academy:
12.b Quality of your preparation for the job market or for further studies.
12.c Quality of placement Assistance/Services.
13. What do you consider to be the strongest aspects of Stein Academy? (Please list):
14. What do you consider to be the weakest aspects of Stein Academy? (Please list):
15. Additional Comments.
Please feel free to provide additional information that you may deem useful: .
Today’s Date: