1. Are you satisfied with your rate of progress?
  2. Which of these statements describes you?
  3. How do you feel about your instructors?
  4. In your opinion, have your instructors shown a personal interest in you?
  5. Students often have problems in the following areas. Check any that describe your feelings.
    Problem Not a Problem Not Sure
    Managing my time
    Classwork too difficult
    Classes meet too often
    Teacher/student relations
    Health/medical problems
    Transportation to class
    Finding child care
    Teachers don't have any time for me
    Other (please describe):
  6. Do you think the services of a counselor would help you in this program?
  7. Please use the space below to make any comments you have about the adult education program, classes, instructors or other staff and how the program could better meet your goals.