CS Department Survey

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Telephone Number:

Email:

URL:

Date of Survey:

What did you like most about the campus? (Check all that apply)

How did you become interested in the university?

Additional Comments:

High-School Graduation Month:

High-School Graduation Year:

Raffle: Enter ten comma separated numbers ranging from 1 through 100.

Likelihood of recommending: Very Likely Likely Unlikely