"Developing Competent, Caring, Committed Profession Educators for Diverse Communities of Learners"

We have an on-going desire to improve our program and your input is highly valued.

Name:
(last, first, Middle, Former)

SSN:

Home Address:

City, State, Zip

1. What year did you graduate from the teacher education program at Capital University?

2. Which certificates/licenses did you receive through Capital?

Any other certificates/licenses? From what institutions?

3. Are you currently employed?

Yes
No

What is your title/position?

School Building/District/Business

Address

City
State
Zip

4. List any graduate studies you have taken.

5. Where have you worked and what positions (teaching and non-teaching) have you held since graduation?

6. Compared to what would you would expect an ideal teacher education program to be like, how would you evaluate the Capital University teacher education program you experienced?

Excellent
Good
Satisfactory
Unsatisfactory

7. In regard to question number 6, why did you choose that answer?

8. Name the advantages of attending the Capital University teacher education program.

9. What suggestions do you have for the Capital University teacher education program.

10. Is there some way we could assist you at this point in time?

11. May we contact your employer for feedback on how well our program prepared you for teaching?

Yes
No

Thanks for your input! Please keep us informed of changes in your professional life. If you have questions, please contact Dr. Michele Winship toll free at 1-8000-289-6289, ext 6264, or locally at 614-236-6301.