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Graduate Status Survey

Major*
Student ID*
Background Information
First Name*
Last Name*
Email
Address after Graduation (Line 1)*
Address after Graduation (Line 2)
City*
State*
Zip Code*
County
Cell #*
Home #
Someone Who Can Always Contact You
First Name
Last Name
Relationship
Permanent Address (Line 1)
Permanent Address (Line 2)
City
State
Zip Code
Phone #

Graduation Information
Graduation Month*
Graduation Year*
Are you graduating with a degree or a certificate?*
Are you going to work for the company you were on internship with?*
- Yes
- No
Do you plan to continue your education?*
- Yes
- No
Please state the name of the school where you plan to continue your education
Please state the major you plan to continue your education in
Do you plan to enter the military?
- Yes
- No
Please state the branch of the military you plan to enter

Employment Information
Have you accepted employment?*
- Yes
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Workplace Information
Name of Company*
Work #*
Address Line 1*
Address Line 2
City*
State*
Zip*
County
Job Information
Name of Supervisor
Supervisor's Title
Supervisor's Email
Beginning Date of Employment*
Your Job Title*
Do you earn an hourly wage or yearly salary?*
- Hourly Wage
- Yearly Salary
Hourly Wage*
Yearly Salary*
Do you receive benefits?*
- Yes
- No
Is your present job related to your training at State Technical College of Missouri?*
- Yes
- No
How did you find your job?*
What location would you like to work in?*
How would you rate the training/education you received at State Technical College of Missouri?
- 5
- 4
- 3
- 2
- 1
Rate from 5 to 1 with 5 meaning excellent and 1 meaning poor
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Linn, MO 65051 info@statetechmo.edu (573) 897-5000

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