Personal Information:
First Name:
Last Name:
E-mail Address:
Current Physical Location (Zipcode):
Which option best describes your current role?
Current Graduate Student
University Educator or Adminstrator
Graduated
Other
Other
What is your current role?
Who is your current employer?
Usage of a free website:
1 being Highly Unlikey to 7 being Very Likely, please answer the following questions:
Create an account on a free website to socialize with educators, graduate students, and professionals in your field:
1
2
3
4
5
6
7
Graduate students currently do not face challenges obtaining internships:
1
2
3
4
5
6
7
Graduate students currently do not face issues meeting their requirements for certification:
1
2
3
4
5
6
7
Certification requirements are being lowered due to difficulties of graduate students finding opportunties to obtaining their required hours:
1
2
3
4
5
6
7
Graduate students can benefit from participating in a mentoring program:
1
2
3
4
5
6
7
Would you be interested in participating in a Mentoring program?
Yes
No
Not Sure
Can we contact you via e-mail regarding any additional questions or updates concerning a free website to support graduate students?
Yes
No
Additional Comments: