18) How could this workshop be improved?
(Mark all that apply)
2012 CASH FOR COLLEGE 19) Did the extra $1,000 scholarship motivate you to
attend today?
No improvement needed STUDENT EXIT SURVEY
Explain in more detail Yes, de nitely motivated me
More one-to-one help Session too long Motivated me a little
We
More translators want to hear from YOU! Tell us about your experience today on attend; didn’t motivate me to attend
Was going to this exit survey.
PLUS, HIGH SCHOOL SENIORS: complete this survey, apply for a Cal Grant by March 2, and you could cash in on an extra
Other: __________________________________________ Didn’t know about it
HIGH SCHOOL SENIORS: THIS IS YOUR OFFICIAL SCHOLARSHIP ENTRY page for
$1,000 scholarship! Seniors who may qualify for AB 540 are eligible for this scholarship, too! See backFORM! details, or go to:
and completing this exit survey, high
By attending a Cash for College workshopwww.californiacashforcollege.org school seniors could qualify for a $1,000
scholarship provided by ECMC. At least one qualifying student from each qualifying workshop who has completed the
WORKSHOP THANK a veri ed Cal Grant GPA by the TO TELL US HOW TO REACH YOU…
2011-12 FAFSA, and submittedYOU! USE THE SPACE BELOW March 2 Cal Grant deadline will be randomly selected to
LOCATION: DATE: / 12
/
receive a scholarship. Seniors who may the space below, high school, college and Cash and if selected must complete an
By providing your contact information inqualify for AB 540 are eligible for this scholarship for College representatives may
How wouldto help you complete the nancial aid process, or to help evaluate the late May, or early June 2012. To claim is
AB 540 A you At least workshop overall? 12) awarded in race/ethnicity? (Mark all that apply)
1) contact you davit. rate thisone scholarship per qualifying workshop will beWhat is yourworkshop program. Your informationthe
scholarship, recipients must shared with the National Student Clearinghouse for evaluation Alaskan Native
American institution of their to verify the Fall of
kept private and may only be attend an accredited, 2-year or 4- year degree granting Indian or purposes,choice in enrollment
Excellent Good Fair Poor
or outside of California) and pursue an associates or bachelors degree. For more information see www.calgrants.org.
2012 (ineducation institutions. Your information will not be shared with any unauthorized persons or organizations.
at higher Asian
2) Before you heard about this workshop, did you know how Black/African American
PLEASE PRINT CLEARLY!
to apply for nancial aid? Hispanic/Latino
Yes No Native Hawaiian or other Paci c Islander
HIGH SCHOOL SENIORS: THIS IS YOUR OFFICIAL SCHOLARSHIP ENTRY FORM!
A little, but not all I needed to know White
high school seniors could qualify for
By attending a Cash for College workshop and completing this exit survey, Other: _______________________ a $1,000
Could you provided by ECMC. At least one qualifying student from each qualifying workshop who has completed the
3) scholarshiphave completed the FAFSA on your own, Decline to Answer
without the help provided by a Cash ed Cal Grant GPA by
2012-13 FAFSA, and submitted a verifor College workshop?the March 2 Cal Grant deadline will be randomly selected to
HIGHProbably, SENIORS: THIS IS are eligible forDo you usually speakif selected must complete an
receive a scholarship. SeniorsSCHOOL but not as well540 YOUR OFFICIAL SCHOLARSHIP ENTRY FORM!other than English
Yes No who may qualify for AB 13a. this scholarship and a language
at home?
AB 540 A davit and agree to apply for a Cal and completing this exit survey, high At leastseniors could qualify qualifying
By attending a Cash for College workshop Dream Act Cal Grant when available. school one scholarship per for a $1,000
4) Was the help you received worth the e ort of attending? Yes No
scholarship be awarded inNot sure or early June 2012. To claim the scholarship, recipients must attend an accredited,
late May,
workshop willprovided by ECMC. At least one qualifying student from each qualifying workshop who has completed the 2-year
Yes No
4- year FAFSA, and submitted a veri their choice GPA by the March 2If yes, what language do you usually speak at home?
13b. Cal outside of California) and pursue an associates
or2012-13degree granting institution ofed Cal Grant in the Fall of 2012 (in or Grant deadline will be randomly selected to or
receive adegree. For more information see to attend 540 are eligible for this scholarship and if selected must complete an
bachelorsbe the rst member of your familywww.calgrants.org.
5) Will you scholarship. Seniors who may qualify for AB
AB 540
college?A davit and agree to apply for a Cal Dream Act Cal Grant when available. At least one scholarship per qualifying
_____________________________________________
PLEASE PRINT CLEARLY! in late May, or early June 2012. To claim the scholarship, recipients must attend an accredited,
Yes No
workshop will be awarded
14) How did you hear about this Cash for pursue workshop?
2-year or 4- year degree granting institution of their choice in the Fall of 2012 (in or outside of California) andCollege an
of education your parent/s information
6) Highest level as it appears on FAFSA morecompleted: see www.calgrants.org. that apply)
associates or bachelors degree. For
Enter Name (Mark all
Did not complete high school School yer/poster Phone call
Student First Name: GED
High School or School counselor Friend/classmate
Some college but no degree Teachers/school sta Family
PLEASE PRINT CLEARLY!
Vocational certi cate
Student Last Name: Radio Community organization
2-year (associates) degree Newspaper Church
4-year bachelor’s degree or higher Website/e-mail Cal-SOAP event/sta
Home Phone: - - Cell Phone: Mailing - - Facebook or Twitter
7) Are you a high school senior? Other:______________________________________
Yes
Home Address: No Family member of senior
15) Did you nish your FAFSA today?
What
8) City: high school do you attend (name of school and city)? Yes (skip to Question 18)
Zip:
Some, not all
_______________________________________________ No
E-mail Address:
9) Are you member of a social networking site? 16) If you didn’t nish your FAFSA today, please tell us
Date of Birth: / /
(Mark all that apply) why: (Mark all that apply)
Facebook Twitter None Thought I had to have taxes completed
Social Security Number (Last 4 digits): I do not have a SSN I do not remember my SSN
Other: _______________________________________ Didn’t bring enough nancial info with me
Technical problem with computer
10) Did you attend with your parent or guardian today? Will submit later on the Internet
Yes Contact:
Additional No Asked for AB 540 help
Other:______________________________________
11) What is your gender?
Phone: - -
Male Female Decline to Answer 17) Would you like more help to complete the FAFSA?
E-mail Address:
Yes Maybe No
TURN OVER TO FINISH SURVEY & SCHOLARSHIP ENTRY FORM
18) How could this workshop be improved?
(Mark all that apply)
2012 CASH FOR COLLEGE 19) Did the extra $1,000 scholarship motivate you to
attend today?
No improvement needed STUDENT EXIT SURVEY
Explain in more detail Yes, de nitely motivated me
More one-to-one help Session too long Motivated me a little
We
More translators want to hear from YOU! Tell us about your experience today on attend; didn’t motivate me to attend
Was going to this exit survey.
PLUS, HIGH SCHOOL SENIORS: complete this survey, apply for a Cal Grant by March 2, and you could cash in on an extra
Other: __________________________________________ Didn’t know about it
HIGH SCHOOL SENIORS: THIS IS YOUR OFFICIAL SCHOLARSHIP ENTRY page for
$1,000 scholarship! Seniors who may qualify for AB 540 are eligible for this scholarship, too! See backFORM! details, or go to:
and completing this exit survey, high
By attending a Cash for College workshopwww.californiacashforcollege.org school seniors could qualify for a $1,000
scholarship provided by ECMC. At least one qualifying student from each qualifying workshop who has completed the
WORKSHOP THANK a veri ed Cal Grant GPA by the TO TELL US HOW TO REACH YOU…
2011-12 FAFSA, and submittedYOU! USE THE SPACE BELOW March 2 Cal Grant deadline will be randomly selected to
LOCATION: DATE: / 12
/
receive a scholarship. Seniors who may the space below, high school, college and Cash and if selected must complete an
By providing your contact information inqualify for AB 540 are eligible for this scholarship for College representatives may
How wouldto help you complete the nancial aid process, or to help evaluate the late May, or early June 2012. To claim is
AB 540 A you At least workshop overall? 12) awarded in race/ethnicity? (Mark all that apply)
1) contact you davit. rate thisone scholarship per qualifying workshop will beWhat is yourworkshop program. Your informationthe
scholarship, recipients must shared with the National Student Clearinghouse for evaluation Alaskan Native
American institution of their to verify the Fall of
kept private and may only be attend an accredited, 2-year or 4- year degree granting Indian or purposes,choice in enrollment
Excellent Good Fair Poor
or outside of California) and pursue an associates or bachelors degree. For more information see www.calgrants.org.
2012 (ineducation institutions. Your information will not be shared with any unauthorized persons or organizations.
at higher Asian
2) Before you heard about this workshop, did you know how Black/African American
PLEASE PRINT CLEARLY!
to apply for nancial aid? Hispanic/Latino
Yes No Native Hawaiian or other Paci c Islander
HIGH SCHOOL SENIORS: THIS IS YOUR OFFICIAL SCHOLARSHIP ENTRY FORM!
A little, but not all I needed to know White
high school seniors could qualify for
By attending a Cash for College workshop and completing this exit survey, Other: _______________________ a $1,000
Could you provided by ECMC. At least one qualifying student from each qualifying workshop who has completed the
3) scholarshiphave completed the FAFSA on your own, Decline to Answer
without the help provided by a Cash ed Cal Grant GPA by
2012-13 FAFSA, and submitted a verifor College workshop?the March 2 Cal Grant deadline will be randomly selected to
HIGHProbably, SENIORS: THIS IS are eligible forDo you usually speakif selected must complete an
receive a scholarship. SeniorsSCHOOL but not as well540 YOUR OFFICIAL SCHOLARSHIP ENTRY FORM!other than English
Yes No who may qualify for AB 13a. this scholarship and a language
at home?
AB 540 A davit and agree to apply for a Cal and completing this exit survey, high At leastseniors could qualify qualifying
By attending a Cash for College workshop Dream Act Cal Grant when available. school one scholarship per for a $1,000
4) Was the help you received worth the e ort of attending? Yes No
scholarship be awarded inNot sure or early June 2012. To claim the scholarship, recipients must attend an accredited,
late May,
workshop willprovided by ECMC. At least one qualifying student from each qualifying workshop who has completed the 2-year
Yes No
4- year FAFSA, and submitted a veri their choice GPA by the March 2If yes, what language do you usually speak at home?
13b. Cal outside of California) and pursue an associates
or2012-13degree granting institution ofed Cal Grant in the Fall of 2012 (in or Grant deadline will be randomly selected to or
receive adegree. For more information see to attend 540 are eligible for this scholarship and if selected must complete an
bachelorsbe the rst member of your familywww.calgrants.org.
5) Will you scholarship. Seniors who may qualify for AB
AB 540
college?A davit and agree to apply for a Cal Dream Act Cal Grant when available. At least one scholarship per qualifying
_____________________________________________
PLEASE PRINT CLEARLY! in late May, or early June 2012. To claim the scholarship, recipients must attend an accredited,
Yes No
workshop will be awarded
14) How did you hear about this Cash for pursue workshop?
2-year or 4- year degree granting institution of their choice in the Fall of 2012 (in or outside of California) andCollege an
of education your parent/s information
6) Highest level as it appears on FAFSA morecompleted: see www.calgrants.org. that apply)
associates or bachelors degree. For
Enter Name (Mark all
Did not complete high school School yer/poster Phone call
Student First Name: GED
High School or School counselor Friend/classmate
Some college but no degree Teachers/school sta Family
PLEASE PRINT CLEARLY!
Vocational certi cate
Student Last Name: Radio Community organization
2-year (associates) degree Newspaper Church
4-year bachelor’s degree or higher Website/e-mail Cal-SOAP event/sta
Home Phone: - - Cell Phone: Mailing - - Facebook or Twitter
7) Are you a high school senior? Other:______________________________________
Yes
Home Address: No Family member of senior
15) Did you nish your FAFSA today?
What
8) City: high school do you attend (name of school and city)? Yes (skip to Question 18)
Zip:
Some, not all
_______________________________________________ No
E-mail Address:
9) Are you member of a social networking site? 16) If you didn’t nish your FAFSA today, please tell us
Date of Birth: / /
(Mark all that apply) why: (Mark all that apply)
Facebook Twitter None Thought I had to have taxes completed
Social Security Number (Last 4 digits): I do not have a SSN I do not remember my SSN
Other: _______________________________________ Didn’t bring enough nancial info with me
Technical problem with computer
10) Did you attend with your parent or guardian today? Will submit later on the Internet
Yes No Asked for AB 540 help
Other:______________________________________
11) What is your gender?
Male Female Decline to Answer 17) Would you like more help to complete the FAFSA?
Yes Maybe No
TURN OVER TO FINISH SURVEY & SCHOLARSHIP ENTRY FORM