Coastal Carolina Community College
Leaver/Withdrawal Survey
Name  
 
  (MM/DD/YYYY)
Curriculum (Please select the program in which you were enrolled)
 
Q1 What was your primary goal for attending Coastal? (Please select only one)
 
Q2 To what extent do you feel you accomplished your goal while attending Coastal? (Please select only one)
Skip to Q4
 
 
Q3 If you did not accomplish your goal while attending Coastal, which of the following describes why you did not acheive that goal and your reason for leaving.
 
 
Q4 What is your current status?
Go to Q5
Q5
Q6 Is your job related to your studies at Coastal?  
Q7 Please indicate your rating of the following services by filling in the most appropriate response.
  Excellent   Above Average   Average   Below Average   Poor  
  Quality of Instruction in program area courses          

  Quality of Instruction in other courses          

  Overall quality of academic program          

  Teaching Facilities          

  Equipment          

  Learning Resource Center          

  Admissions Procedures          

  Academic Advising          

  ADA Accommodations          

  Financial Aid          

  Veterans Affairs          

  Registration Procedures          

  Student Activities          

  Business Office          

  Bookstore          

  Cafeteria          

  Security          

  Computer Resources on Campus          

  College Foundation          

  Overall Quality of the college          

  Overall Coastal Experience          
Q8 Please indicate your response to the following questions.
  Yes   No   Not Sure  
  Do you plan to re-enroll at this community college during the next year?      

  If you were to begin again, would you choose to attend this community college?      
Q9 Could we have done anything differently that may have helped you remain in college?                                                                                Could we have provided you . . . (select all that apply)
 
Q10
 
   
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