- Total Family Income per year
- Under $5,000
- $5,000 - $9,999
- $10,000 - $14,999
- $15,000 - $19,999
- $20,000 - $24,999
- $25,000 - $29,999
- $30,000 - $39,000
- $40,000 and over
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- I would be interested in taking a course. yes ( ) no ( )
- I would have money available for education. yes ( ) no ( )
- If so, I would spend $______ for a course.
- I would travel up to_______ miles to take a course.
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In the past 2 years have you attended any of the
following? (if yes, please specify)
- Community school
- Workshop, seminar, conference
- Correspondence course
- School
- University
- Other
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- Please list the schools, organizations or agencies in
your area. that offer courses:
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