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Sample SURVEY QUESTIONNAIRE

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					                         SURVEY QUESTIONNAIRE FOR A TRACER STUDY

Hello,
       Thank you for allowing us to communicate with you. Our College recognizes the importance of each
member and as a tradition, we would like to be updated and be connected with you wherever you may be.
We sincerely request you to fill in the important information in this questionnaire. Please answer the
questions as honest as possible. Truthful responses would provide strong bases in continuing or correcting
the "practices" of UM College of Nursing. We assure you that all responses will be held strictly confidential.
     We appreciate your time and generosity. God Bless.
                                                                                            - Your Alma Mater.



  I. Please provide correct information for each item (*required)

         First Name*

         Last Name*

         Middle Name*

         Civil Status*          Single                            Ethnicity*

         Birthdate*             June 07, 1986


         Year Graduated in UM*           2007


         Present Location (Complete Address)*




         Permanent Address*         NPC Compound Calumpang, General Santos City




         Zip Code*       8000



         Provincial Address*



         Mobile Phone Nos.*

         Residencial Phone No.*

         Email*
Preferred Mailing Address:



Are you a NLE Passer?           /*
                                       YES                  NO           License No.

Were you able to get a job prior to taking NLE?                    YES              * NO

At the time to took the NLE, were you employed as well?                       YES                * NO


Can you say that you had enough support (financial, moral, emotional, etc) while you were preparing for
the board examination?

                    YES.               NO.         If your answer is no, you may elaborate.




II. Career Status

     Please tell us about the status of your career. In the selection of choices below, there is no
right or wrong answer. Again, data will be used with utmost confidentiality. Mark the space
inside the box that represents your choice with X .

                  On Probationary                                        Volunteer

                   Regular / Full-Time                                    Trainee (with pay/allowance)

                  Part-Time                                           Job seeking                     Contractual

                   Basis                                         Others, pls specify:




III. Type of Organization Presently Connected (Leave blank if not applicable)


    Government              (Health Institution)                     Private (Non - health Institution)

                  
                  Government (Non-health Institution)              Self - Employed

                   Private (Health Institution)                         Others, pls. specify:
IV. Summary of Employment (Select all that apply). Leave blank if not applicable.


  Present Employer                   Address                            Duration of service rendered
                                                                       (Pls. indicate dates covered)




  Previous Employer/s                   Address                         Duration of service rendered
                                                                        (Pls. indicate dates covered)

                                                                         5 months
 1. Netxpress Internet Cafe




 2.




 3.




V. After graduation, how many months had passed, before you were hired in the company or
   institution you applied? (Leave blank if not applicable).


       *         1-3                              10-12

                      4-6                            13-18

                      7-9                            more than 19 months




      
VI. Current Job Position and its Description. (Leave blank if not applicable).


   Current Job Position

   Current Job Description (pls. elaborate roles & responsibilities)




VII. What preparations do you consider, for the advancement of your career? (Rank
     responses from 1 to 5).

    [ 2]   Acquire more training in nursing procedures.
    [ 4]   Enroll in review classes for international exams like CGFNS, NCLEX, etc.
    [1 ]   Acquire more year/s of clinical experiences.
    [ 5]   Pursue Masters of Arts in Nursing or other related graduate courses in Nursing.
    [ 3]   Work out the applications to work abroad.

VIII. Membership in Clubs/Organizations (Select all that apply) Leave blank if not
      applicable.

   Professional Organizations (pls. write down)
    Philippine Nurses Association




   Civic Organizations (pls. write down)
   Others (pls. write down)




IX. Which of the following, you think you can be effective as, 2-5 years from now?
    (Rank responses from 1 to 8.)

               [ 1]    Staff Nurse (in one of the hospitals of your country)
               [ 5]    Health Care Volunteer
               [ ]     Community Leader/Organizer
               [ 7]    Staff Nurse (in one of the hospitals abroad)
               [ 4]    Nurse Educator/Clinical Instructor
               [ 2]    Hospital Administrator (in local setting)
               [8 ]    Hospital Administrator (abroad)
               [3 ]    Company Nurse
               [ 6]    Community Health Nurse


X. What advices would you give to students interested in Nursing?

    Pursue their dreams of becoming a nurse and they will never regret especially if they get their license..unexplainable
        feeling.. =)




XI. If UM is NOT your Alma Mater, would you recommend the school to other incoming
    freshmen students? (indicate also your reasons).

             *  YES                            NO                       MAYBE


XII. At this point in time, how do you think UM can help you in your general career
     concerns?
    Find a job..hehehehe..and continue praying for our success..
XIII. What do you think are the "best" things about University of Mindanao, College of
      Nursing?


      Faculty members are very approachable eventhough they are very tired of doing something.
      Our Dean, Mrs Lariego, is always their for us everytime we need her.
      The environment is conducive for learning eventhough there are some rooms that is very hot..
      Clinical Instructors teaches us so well.
      Tuition fee is affordable.
      Very supportive Clinical Instructors especially during exams and they always gave us words of encouragement.




XIV. Which aspect/s University of Mindanao, College of Nursing, should improve more
   and why?

      I think in assigning students in the clinical area because during our time, not all of us was assigned to all areas that was
            affiliated by UM.




XV. What are your suggestions to keep the good interactions and partnership among
    BSN alumni of UM and of the UM Community?
      Annual gathering. =)




Thank you for sharing your precious time, kindly email back (as an “attached file”) this questionnaire to graciah_98@yahoo.com as

                                                 soon as you have completely filled it up.