Student Name: First Name
Last Name
Email:
1. Gender :
Male
Female
2. Ethnicity: (You may check more than one, as appropriate)
African/Black American
American Indian/Alaskan Native
Asian & Pacific American
Latina/Latino/Hispanic American
White American
Other
3a. Education : Choose the grade that you are in now or, if it is summer, check the grade you will enter next fall:
6th
7th
8th
9th
10th
11th
12th
Graduating
3b. Name of High School (or Home Schooled) :
3c. Expected High School Graduation Year:
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
4. From the list below, check which classes you are currently taking in school this year OR, if you have completed a school year, the classes that you plan to take in your next school year. Check all that apply.
8. What do you plan to do when you graduate from high school?
Go to a college or university
Attend a technical school (for example: business school, beauty school, technology school, etc)
Get a full-time job
Join the military
Don’t know
Other
If other - please specify:
9.
What is the highest level of formal education completed by your parents?
High School
2-Year Degree
College/University
Graduate School
Not Applicable
Mother
High School
2-Year Degree
College/University
Graduate School
Not Applicable
Father
14. What do you think information assurance or cybersecurity specialists do that could make a difference in your life (either good or bad)? Make a list in the space below.
15.
What does the word cybersecurity mean to you?
Directions:
Below are statements about studying STEM careers such as cybersecurity. To the left of each statement indicate whether you Strongly Disagree, Disagree, Slightly Disagree, Neither Disagree nor Agree, Slightly Agree, Agree, Strongly Agree, or Don’t Know by choosing the appropriate selection.
To the right of each statement circle the appropriate number to indicate whether the statement is Very Unimportant, Unimportant, Neither Important nor Unimportant, Important, or Very Important to you in terms of completing an engineering program.
To what extent do you AGREE? How IMPORTANT is this?
0 = Strongly Disagree
0 = Very unimportant
1 = Disagree
1 = Unimportant
2 = Slightly Disagree
2 = Neither Important nor Unimportant
3 = Neither Disagree nor Agree
3 = Important
4 = Slightly Agree
4 = Very Important
5 = Agree
6 = Strongly Agree
7 = Don’t Know
16.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
I can relate to the people around me in my classes
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
17.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
I think I can succeed in a STEM curriculum field like cybersecurity
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
18.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
Someone like me can succeed in a STEM curriculum field like cybersecurity
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
19.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
I can succeed in a STEM curriculum field like cybersecurity while not having to give up participation in my outside interests (e.g., extracurricular activities, family, sports)
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
20.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
I can relate to the people around me in my extracurricular activities
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
21.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
I think I will succeed (earn an A or B) in my science courses
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
22.
Extent
Strongly Disagree
Disagree
Slightly Disagree
Neither Disagree nor Agree
Slightly Agree
Agree
Strongly Agree
Don't know
I think I will succeed (earn an A or B) in my math courses
Importance
Very Unimportant
Unimportant
Neither Important nor Unimportant
Important
Very Important
Directions: For each statement below indicate whether you Strongly Disagree, Disagree, Slightly Disagree, Neither Disagree nor Agree, Slightly Agree, Agree, Strongly Agree, or Don’t Know by selecting the appropriate number or symbol.
36. At the present time, how confident are you that you will be enrolled in an information assurance/cybersecurity program in the next 5 years?
Not at all confident; I am already planning not to pursue information assurance/cybersecurity
Not confident; it is highly likely I will not complete an information assurance/cybersecurity program
There’s about a 50% chance that I’ll be in information assurance/cybersecurity
I’m fairly confident that I will be in information assurance/cybersecurity
I’m very confident that I will be in information assurance/cybersecurity
37. At the present time, how confident are you that you will complete any information assurance/cybersecurity program?
Not at all confident; I am already planning not to pursue information assurance/cybersecurity
Not confident; it is highly likely I will not complete an information assurance/cybersecurity program
There’s about a 50% chance that I’ll complete an information assurance/cybersecurity program
I’m fairly confident that I will complete an information assurance/cybersecurity program
I’m very confident that I will complete an information assurance/cybersecurity program
38. At the present time, how confident are you that you will complete any degree in college
Not at all confident; I am already planning not to attend college or to drop out of college
Not confident; it is highly likely I will not complete any college degree
There’s about a 50% chance that I’ll complete a college degree
I’m fairly confident that I will complete a college degree
I’m very confident that I will complete a college degree
Tell Us Why You are Here
39. Why did you choose to attend this activity? Check all that apply.
40. How did you hear about this activity? Check all that apply.