CID School Alumni Survey

1. Welcome CID Alum!

This survey is designed for adult school alumni of Central Institute for the Deaf in St. Louis, Missouri. Please take a moment to answer the 10 questions below.

Your answers are confidential. Thank you for helping us gather important information that will help us better understand how a CID education affects the lives of individuals with hearing loss.

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* 1. What is your name?

First name:

Last name:

Maiden name (if applicable):

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* 2. What is your email address?

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* 3. What year were you born?

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* 4. What years did you attend CID?

From:

To:

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* 5. Please describe your hearing loss by checking ALL that apply.

Mild-Moderate

Severe-Profound

Since birth

After acquiring some language

Progressive loss over time

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* 6. Please check all institutions from which you have graduated AND in which you are currently enrolled.

CID

High school

Technical school

A two-year college or university program

A four-year college or university program

A post-graduate program

I am in high school and plan to go to college.

I am in high school and DO NOT plan to go to college.

I attended some college, but did not/will not graduate.

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* 7. Please list the colleges and universities you have attended along with the following, as applicable, for each: your major, degree obtained and year of graduation or expected graduation.

College/university:

Major:

Degree:

Year of graduation:

College/university:

Major:

Degree:

Year of graduation:

College/university:

Major:

Degree:

Year of graduation:

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* 8. Please give your occupation, job title and place of work.

Current occupation (or type "unemployed," "student" or "retired"):

Current job title:

Name of current business or organization:

If retired, name of former business or organization:

If retired, former job title or occupation:

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* 9. What is your annual income range? (If retired, what was your income at the height of your earning capacity?) Your answer is confidential.

	Less than $20,000	$20,000-$40,000	$40,000-$60,000	$60,000-$80,000	$80,000-$100,000	More than $100,000
Income range	Income range Less than $20,000	Income range $20,000-$40,000	Income range $40,000-$60,000	Income range $60,000-$80,000	Income range $80,000-$100,000	Income range More than $100,000

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* 10. How beneficial is your CID education in the following areas:

	Not beneficial	Somewhat beneficial	Beneficial	Very beneficial	Key to my success
Career	Career Not beneficial	Career Somewhat beneficial	Career Beneficial	Career Very beneficial	Career Key to my success
Education	Education Not beneficial	Education Somewhat beneficial	Education Beneficial	Education Very beneficial	Education Key to my success
Workplace	Workplace Not beneficial	Workplace Somewhat beneficial	Workplace Beneficial	Workplace Very beneficial	Workplace Key to my success
Social situations	Social situations Not beneficial	Social situations Somewhat beneficial	Social situations Beneficial	Social situations Very beneficial	Social situations Key to my success
Living skills	Living skills Not beneficial	Living skills Somewhat beneficial	Living skills Beneficial	Living skills Very beneficial	Living skills Key to my success
Income	Income Not beneficial	Income Somewhat beneficial	Income Beneficial	Income Very beneficial	Income Key to my success
Quality of life	Quality of life Not beneficial	Quality of life Somewhat beneficial	Quality of life Beneficial	Quality of life Very beneficial	Quality of life Key to my success