Demographic Questions
1. What is your name? 2. What is your age?
Family
3. Are you married?
4. Do you have any children? a. Yes
b. No
5. How many siblings do you have? a.
b. I do not have any siblings
6. If you have any siblings, have any of them graduated from or have a certification from: a. A community college
b. A four-year college c. None of the above
d. I do not have any siblings
7. What is the highest level of education your mother obtained? a. A high school diploma or GED
b. A community college certification c. A community college degree d. A four-year college degree
e. A masters degree
Demographic Questions
8. What is your name? 9. What is your age?
Family
10. Are you married?
11. Do you have any children? a. Yes
b. No
12. How many siblings do you have? a.
b. I do not have any siblings
13. If you have any siblings, have any of them graduated from or have a certification from: a. A community college
b. A four-year college c. None of the above
d. I do not have any siblings
14. What is the highest level of education your mother obtained? a. A high school diploma or GED
b. A community college certification c. A community college degree d. A four-year college degree e. A masters degree
f. A doctorate degree g. Unknown
15. What is the highest level of education your father obtained? a. A high school diploma or GED
b. A community college certification c. A community college degree d. A four-year college degree e. A masters degree
f. A doctorate degree g. Unknown
16. If you have siblings, are any of them currently attending college? a. Yes
b. No
c. I do not have any siblings 17. What is your current living situation?
a. Live at home with parent/guardian/family member(s) b. Rent a room or apartment
c. In a program that provides housing and/or meals d. Other
18. Are you or have you ever been in a foster home? a. Yes
Employment Status
19. What is your current work status?
a. Full time (more than 32 hours per week) b. Part time (15-32 hours per week)
c. Less than 15 hours per week d. Not currently employed
20. Do you have a person whom you consider a mentor specifically to help you with your education?
a. Yes, and he is an African American male b. Yes, and he is male, but not African American c. Yes
d. No
21. Have you ever been suspended or expelled from school? a. Suspended
b. Expelled c. Both
d. I have been suspended or expelled from school
Community College Success
22. Have you chosen a college major? a. Yes
23. Is this the first community college you have attended? a. Yes
b. No
24. How long have you been attending this community college? a. Less than one year
b. One to two years c. Two to three years d. More than three years
25. Do you attend college during the summer sessions? a. I attend one summer session
b. I attend both summer sessions
c. I do not attend school during the summer sessions 26. Do you receive any of the following financial aid resources:
a. I only receive a BOGG fee waiver
b. I receive a BOGG fee waiver and a full PELL grant
c. I receive a BOGG fee waiver, a full PELL grant and work-study d. I receive a BOGG fee waiver and a partial PELL grant
e. I am responsible for paying all of my tuition and fees f. Other
27. Does anyone in your family support you financially so that you can attend college? (Does anyone assist you with paying for your books, fees, money for transportation)?
a. Yes a family member supports me
c. No
28. When you completed the assessment test, did the results show you had to: a. Enroll in at least one remedial math course
b. Enroll in at least one remedial English course
c. You did not have to enroll in any remedial math or English course 29. Are you actively utilizing any of the following campus resources:
a. STAR Program b. EPOS
c. CARE
d. Computer lab for completing class assignments e. DSPS
f. Valley Bound g. Cal Works
h. First Year Experience
i. I do not utilize any campus resources 30. Do you participate in any of the following:
a. Campus athletics
b. Campus club (Tuanimi or other club) c. Student government
d. None of the above
31. What is your current cumulative GPA: a. 3.50 or higher
c. 2.50 to 3.00 d. 2.00 to 2.49 e. Below 2.00
f. I do not know my current cumulative GPA
32. What was your GPA for the last semester you completed: a. 3.50 or higher
b. 3.00 to 3.9 c. 2.50 to 3.00 d. 2.00 to 2.49 e. Below 2.00
f. I do not know my GPA for the last semester I completed 33. What was your GPA when you graduated from high school:
a. 3.50 or higher b. 3.00 to 3.9 c. 2.50 to 3.00 d. 2.00 to 2.49 e. Below 2.00
f. I do not know/remember my GPA from high school 34. Do you attend college full or part time?
a. Full time taking more than 12 units in a semester b. Full time taking 12 units in a semester
c. Part time taking nine to 12 units in a semester d. Part time taking six to nine units in a semester
e. Part time taking only one course a semester
35. Do you choose the classes you want to take each semester or does someone help you choose your classes?
a. I choose my classes on my own because I have a degree plan from the counseling office
b. I get someone off campus to help me choose my classes c. I choose my classes on my own
36. Do you work on or off campus while attending college? a. I work full time on campus
b. I work part time on campus c. I work full time off campus d. I work part time off campus e. I am not currently working
37. How many African American male instructors have you had while attending this community college?
a. I have not had any African American male instructors b. 1-2
c. 2-3
d. More than 3
38. How many units of study have you completed? 39. Do you plan to transfer to a four-year university?
b. I will transfer to a four-year university, but not right after graduating community college
APPENDIX C