UCLA CEED | Form Detail

UCLA MESA 12th Grade Exit Survey

Directions

Please fill out the following survey concerning your experience with the UCLA MESA program.

Question 1

Name:

Question 2

Phone:

Question 3

High School:

Question 4

E-mail:

Question 5

Permanent Address:

Question 6

How many years were you in MESA?

Question 7

What is your GPA?

Question 8

To which colleges or universities did you apply?

Question 9

Which 4- or 2-year college are you attending in the fall?

Question 10

If you are not attending college, please specify your plans for next year (i.e.: work full-time, military).

Question 11

What is your intended major?

Question 12

Did you take the SAT I?

No Yes

Question 13

Please list your SAT I scores in this order: Verbal, Math, Writing, Total Score.

Question 14

Did you take the SAT II?

No Yes

Question 15

What colleges or universities did you visit during high school?

Question 16

What is the highest math level that you will complete upon graduation?

Question 17

State the number of Honors and Advanced Placement (AP) courses you have taken.