ECUA Interest Survey

Would you be interested in affordable Community College courses and degrees in or near your home community?
YesNo
What type of associate degrees or certifications would you be interested in?
Nursing        Business     Engineering
Technology   Vocational   Oil And Gas
CDL    Other
If Other:

If Yes, What is the furthest you would be willing to travel for classes?
5 - 15 minutes
15 - 30 minutes
30 - 45 minutes
45 - 60 minutes
60 - 90 minutes
Greater than 90 minutes
When would you like to see the courses offered?
AM PM Late PM/Evenings Weekends Other   If Other:

What County do you live in? Cameron Clarion Clearfield Crawford Elk Forest Jefferson McKean Potter Venango Warren

Current Highest Level of Education:
In High School Looking to Complete GED High School Degree or GED Some College College Degree

Employment Status:
Employed  - Industry:
Unemployed  - Previous Industry:

Would you be willing to help recruit others into these programs?YesNo
Would you like to receive Email updates on new courses, degrees, certifications, and general ECUA information?
YesNo Email:   

Would you like to receive Postal Mail updates on new courses, degrees, certifications, and general ECUA information?
YesNo Address 1: , Address 2:
City: , PA Zip:

Would you like to receive Mobile updates on new courses, degrees, certifications, and general ECUA information?
YesNo Mobile Phone: