Survey Form

Welcome to the University of Phoenix, Detroit Campus

Educational Needs Analysis

This survey was devloped to determine if there is enough employee interest in attending the University of Phoenix, Detroit Campus.

1. Employer's Name: * Required Field

2. What is your current job level?

	A.		Hourly paid associate in manufacturing, distribution or maintenance
	B.		Other non-management or hourly paid associate (i.e. sales, administrative or clerical)
	C.		Professional team leader, supervisor, manager or senior manager
	D.		Director or senior director
	E.		Executive management

3. What level of education have you completed?

A.	High School/GED	E.	Associate Degree
B.	Under 24 College Credits	F.	Bachelor's Degree
C.	24 to 60 College Credits	G.	Master's Degree
D.	Over 60 College Credits	H.	Ph.D./Doctorate

4. Please indicate the importance you place on the on the following goals. Rate Extremely Important (5) to Not Important (1) for each of the following:

	A.	To gain or improve job specific skills.
	B.	To qualify for promotional opportunities.
	C.	To improve verbal communication skills.
	D.	To improve written communication skills.
	E.	To improve professional teamwork skills.
	F.	To obtain a certificate.
	G.	To earn a degree.

5. Please rate the following criteria as it relates to your decision to attend a particular institution.

	A.	Small class size
	B.	Convenient time
	C.	Convenient location
	D.	Amount of time to degree completion
	E.	Faculty with real-world experience
	F.	Classmates who are working professionals
	G.	Application based learning environment
	H.	Reputation of Institution

6. Which of the following programs are of the most interest to you:

7. Would you be interested in pursuing a degree program? Yes No

8. Is there a certain time or day you would like to attend class?

Monday

Tuesday

Wednesday

Thursday

Please choose time: Morning Evening Saturday

9. Would you be able to begin attending class within the next 90 days? Yes No

10. Would you be interested in attending a "Lunch and Learn" Session? Yes No

If yes, which would you prefer?

(Hold the CTRL key for PC or Command key for MAC to select multiple options)

Contact Information

Required fields are marked (*).

First Name:*		Last Name:*

Street Address:*		City:*

State:*		Zip Code:*

Home Phone:*		Work Phone:*

Home E-mail:		Work E-mail: