Coastal Carolina Community College
Leaver/Withdrawal Survey
Name
SSN or Student ID:
Today's Date:
(MM/DD/YYYY)
Curriculum
(Please select the program in which you were enrolled)
College Transfer
(AA, AE, AFA, AGE, AS)
Computer Programming & Development
Electronics Engineering Technology
Medical Office Administration
Accounting & Financial Services
Cosmetology
Emergency Management
Network Management
Air Cond./Heat/Refrigeration
Criminal Justice Technology
Emergency Medical Science
Office Administration
Architectural Technology
Culinary Arts
Fire Protection Technology
Paralegal Technology
Associate Degree Nursing
Dental Assisting
Health/Fitness Science
Practical Nursing
Automotive Systems Technology
Dental Hygiene
Hospitality Management
Surgical Technology
Basic Law Enforcement Training
Diesel/Heavy Equipment Technology
Information Systems
Web Administration & Design
Business Administration/ Entrepreneurship
Early Childhood Education
Manicuring/Nail Technology
Welding Technology
Collision Repair/Refinishing Technology
Electrical Systems Technology
Medical Laboratory Technology
Q1
What was your primary goal for attending Coastal? (Please select only one)
Graduate with an Associate Degree, Diploma, or Certificate
Enhance my job skills in my present field of work but not to graduate from Coastal
Enhance my job skills for a new line of work but not to graduate from Coastal
To take courses to transfer to another college but not to graduate from Coastal
Take courses for personal interest only
Q2
To what extent do you feel you accomplished your goal while attending Coastal? (Please select only one)
Fully accomplished
Skip to Q4
Partially accomplished
Not accomplished
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.
Job conflict
Medical Problems
Schedule conflicts
New Employment
Moved to new area
Transferred to another College
Financial hardship
Lack of interest in pursuing course of study
Academic
Family circumstances
Dissatisfied with quality of instruction
Personal
Military
Dissatisfied with Instructor
Courses that I need are not currently being offered
Childcare Problems
Dissatisfied with Services
Q4
What is your current status?
Employed
Go to Q5
Enrolled at another Community College/University
Neither
Q5
If employed, what is your job title?
Q6
Is your job related to your studies at Coastal?
Yes
No
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 program area courses Excellent
Quality of Instruction in program area courses Above Average
Quality of Instruction in program area courses Average
Quality of Instruction in program area courses Below Average
Quality of Instruction in program area courses Poor
Quality of Instruction in other courses
Quality of Instruction in other courses Excellent
Quality of Instruction in other courses Above Average
Quality of Instruction in other courses Average
Quality of Instruction in other courses Below Average
Quality of Instruction in other courses Poor
Overall quality of academic program
Overall quality of academic program Excellent
Overall quality of academic program Above Average
Overall quality of academic program Average
Overall quality of academic program Below Average
Overall quality of academic program Poor
Teaching Facilities
Teaching Facilities Excellent
Teaching Facilities Above Average
Teaching Facilities Average
Teaching Facilities Below Average
Teaching Facilities Poor
Equipment
Equipment Excellent
Equipment Above Average
Equipment Average
Equipment Below Average
Equipment Poor
Learning Resource Center
Learning Resource Center Excellent
Learning Resource Center Above Average
Learning Resource Center Average
Learning Resource Center Below Average
Learning Resource Center Poor
Admissions Procedures
Admissions Procedures Excellent
Admissions Procedures Above Average
Admissions Procedures Average
Admissions Procedures Below Average
Admissions Procedures Poor
Academic Advising
Academic Advising Excellent
Academic Advising Above Average
Academic Advising Average
Academic Advising Below Average
Academic Advising Poor
ADA Accommodations
ADA Accommodations Excellent
ADA Accommodations Above Average
ADA Accommodations Average
ADA Accommodations Below Average
ADA Accommodations Poor
Financial Aid
Financial Aid Excellent
Financial Aid Above Average
Financial Aid Average
Financial Aid Below Average
Financial Aid Poor
Veterans Affairs
Veterans Affairs Excellent
Veterans Affairs Above Average
Veterans Affairs Average
Veterans Affairs Below Average
Veterans Affairs Poor
Registration Procedures
Registration Procedures Excellent
Registration Procedures Above Average
Registration Procedures Average
Registration Procedures Below Average
Registration Procedures Poor
Student Activities
Student Activities Excellent
Student Activities Above Average
Student Activities Average
Student Activities Below Average
Student Activities Poor
Business Office
Business Office Excellent
Business Office Above Average
Business Office Average
Business Office Below Average
Business Office Poor
Bookstore
Bookstore Excellent
Bookstore Above Average
Bookstore Average
Bookstore Below Average
Bookstore Poor
Cafeteria
Cafeteria Excellent
Cafeteria Above Average
Cafeteria Average
Cafeteria Below Average
Cafeteria Poor
Security
Security Excellent
Security Above Average
Security Average
Security Below Average
Security Poor
Computer Resources on Campus
Computer Resources on Campus Excellent
Computer Resources on Campus Above Average
Computer Resources on Campus Average
Computer Resources on Campus Below Average
Computer Resources on Campus Poor
College Foundation
College Foundation Excellent
College Foundation Above Average
College Foundation Average
College Foundation Below Average
College Foundation Poor
Overall Quality of the college
Overall Quality of the college Excellent
Overall Quality of the college Above Average
Overall Quality of the college Average
Overall Quality of the college Below Average
Overall Quality of the college Poor
Overall Coastal Experience
Overall Coastal Experience Excellent
Overall Coastal Experience Above Average
Overall Coastal Experience Average
Overall Coastal Experience Below Average
Overall Coastal Experience Poor
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?
Do you plan to re-enroll at this community college during the next year? Yes
Do you plan to re-enroll at this community college during the next year? No
Do you plan to re-enroll at this community college during the next year? Not Sure
If you were to begin again, would you choose to attend this community college?
If you were to begin again, would you choose to attend this community college? Yes
If you were to begin again, would you choose to attend this community college? No
If you were to begin again, would you choose to attend this community college? Not Sure
Q9
Could we have done anything differently that may have helped you remain in college? Could we have provided you . . .
(select all that apply)
help in getting a job?
tutoring?
help with writing?
help in obtaining financial aid?
personal counseling?
help with math?
help with childcare?
help with reading?
help with study skills?
Q10
Please add any comments or suggestions in the box below:
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