Exit Report � Summary of Performance

							               Agreement to Participate: Student Over 18 Years of age
Dear Student,
You are being asked to take part in an Oregon Department of Education (ODE) project. As
you are 18 or older your signature is required to participate in this interview.
As you know, leaving high school is a time of change. It is important to learn how well
prepared students are for life after high school, particularly if they are making progress
toward their goals of getting a job or continuing in education.
After reading the following information, check the YES or the NO box, sign your name,
and return the form. You will be given a copy of this signed form if you so request,
including a phone number to call, if you have any questions.
1) Project Description: This interview asks about your plans for the next 12 months. If
   you are called by your district next spring you will be asked questions about what you
   have done since leaving high school. Your answers will be combined with those of
   other students to let school personnel know how to improve their services for high
   school students.
2) Explanation of Procedures: You are being asked to participate in an interview
   before you leave high school, and may be called for a second interview the spring of
   the year after you leave school.
3) Confidentiality: In the telephone survey, your name will be known by the person who
   calls you, but the answers you give will not have your name on them, nor will your
   telephone number or other contact information be shared with anyone else.
4) Information will be stored in a secure location until the project is finished and then
   the personal information given to us for this study will be destroyed.
5) Why Should You do the Interviews? Students who complete interviews help their
   teachers and high schools understand how to work with students to plan for their
   future, and set goals they can reach. Your answers about your experiences will be
   used to help other students, both while they are in high school and after they leave.
   District results are provided to the Oregon Department of Education, and used for
   required state and federal reports.
6) Is There Any Reason Not To Take Part In these Interviews?
   No reason that we can think of, but you can check the NO box below. If you mark the
   YES box, then decide not to be included, you can quit at any time.

       Yes, I agree to take part in this interview.
       No, I do not wish to take part in this interview.
_______________________________________              _____________________
Student Signature                                    Date

__________________________________                   _____________________
Student Name (please PRINT)                          (OFFICE USE- SSID number-required)


  If you have questions please call or
  email:                                           Western Oregon University
  Pattie Johnson (Principal Investigator)          503-838-8779
  Teaching Research Institute                      johnsop@wou.edu
Exit Interview – General Education Students

Name: _____________________ Birth Date: ___/___/_____ SSID: ________ School: ___________________


Goal: What would you like to do after leaving high school? _____________________________
_____________________________________________________________________________
1. In the next 12 months, do you plan to go on to college or further education? Yes No
      a. Have you submitted any applications?                Yes No
      b. Have you visited any campuses?                      Yes No
2. In the next 12 months, do you plan to work?               Yes No
      a. What kind of work do you want to do? ________________________________________
      b. How would you get to work?  Walk/bike/get rides  Bus  Drive  Other ______
      c. Do you currently have a paid job?                   Yes No
      d. What do you currently do for your job? _______________________________________
      e. How do you get to work?  Walk/bike/get rides  Bus  Drive  Other _________
      f. Have you done volunteer work?                       Yes No
      g. Have you received vocational training for a job? Yes No
3.   Are you considering serving in the military?            Yes No
       a.   If so, have you talked with a recruiter?         Yes No
4.   Where do you plan to live in the fall?  Parents  Campus/base  Apartment  Other
5. What was the most helpful part of being in high school? ______________________________
     ______________________________________________________________________________
6. What do you wish you would have had more of? _____________________________________
_______________________________________________________________________________
7. Do you feel your high school classes helped you get ready for life after high school?
      Yes, most of them  _Maybe, some of them  No, not very much

CONTACT INFORMATION:

Name                 Cell Phone Number          Home Phone Number       E-Mail /face book/ MySpace

Student:

Parent/guardian:

Parent/relative:

Friend:

Address to send a reminder card next spring:           ________________________________________
                                                       ________________________________________
           Thank you for your participation, the interview is done!
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