1. Do you think the supplementary service(s) (if any) offered through your program are adequate for the female students in Your program?
    Yes        No
  Comment: ___________________________________________________________
  _________________________________________________________________
  __________________________________________________________________
C. STUDENT PROFILE *
   * Please Indicate whether the figures given here are exact

estimates

 
 
  1. Number of Students in Program Females________________ Males_________________
 
  1. Average age of students Females_____________________Males____________________
 
  1. Primary occupations of student Females________________ Males____________________
 
  1. From how far away do students come to attend the program?
    _________________________________________________________________________
 
  1. How many women In your program have children under age 12? ____________________
 

D. INSTRUCTOR PROFILE

 
  1. Sex Male    
 Female
  1. Age  Under 30
        30-40
 41-50
51 or older
 
  1. What is your academic background?
    High School Diploma     College Diploma Specify     ________________________

            Specify

    University Degree _______________________________________________

    Specify highest degree attained and discipline of professional area

    Other________________________________________________________

           Specify
   
  1. What was your occupation before you began your work in this program?
    _______________________________________________________________
 
  1. What is your employment status In the program?
         Part-time paid position No of hours_________ Pay per hour $_________
       
       Full-time paid position: Annual Salary S_________
   
            Volunteer position No of hours_____________
 
 
  1. How long have you been employed In this program?
    ______________________________________________________________
 
  1. What are your official responsibilities In this program?
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
 
  1. Do you have any training in teaching adults who require basic education skills?
    Yes_____________________________________No
  Specify
 
  1. How much experience do you have In teaching Adult Basic Education?
    1 year or less
    2 years
    3 years
    4 years
    5 years
    6 or more years
   
 
  1. When you use the term "literacy" what do you mean?
    _______________________________________________________________
    _______________________________________________________________
    _______________________________________________________________
    _______________________________________________________________


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