College of Health Professions Exit Survey

First Name: *

Last Name: *

Year of Graduation:

Year of Program Completion:

Program: *

Gender:

Alternate E-mail Address:

Permanent Address:

City:

State:

Country:

Ethnicity (optional):

Keeping Current

Would you be interested in receiving the CHP Newsletter?:

Yes No

Would you be interested in attending CHP events?:

Yes No

Would you be interested in attending the Homecoming Football Game and BBQ with CHP Faculty and Staff?:

Yes No

Would you be interested in attending or/presenting at a CHP Development event?:

Yes No

Staying in Touch/Newsletter information

Would you send us updated personal information?:

Yes No

If yes, please share your news with us. For example, upcoming marriages; expected births; job advancements:

COLLEGE OF HEALTH PROFESSIONS EXIT SURVEY