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The Effects of Counseling on The Potential Drop-out


Both Carver students and students from the other school are to complete the same survey at the beginning and end of the counseling strategy.The results will be analyzed and interpreted. Each student will also be interviewed.

1. Name


3. Number of siblings in childhood family

4.Birthplace City_________ State__________

5. Number of parents in childhood family

6. Educational background of parents: Mother________ Father__________

7. Type of school last attended: Public_______ Private_________________

8. Number of siblings who completed high school

9. Age of your parents at your birth: Mother________ Father____________

10.Religion: Protestant___ Catholic__ Baptist________ Other___________

11. What is your vocational choice?: First________Second_________Third___

12. Number of years of schooling

13. What are your educational goals?

14. What do you like best about your school?

15. What do you like least about your school?

16. Why do you want to remain in school?

17. Do you intend to further your education after graduation?

18. List some of the reasons you chose your present school?

19. What is the income level of you or your parents?

Below $10,000




Above$ 50,000

20. Do you have plans for college?

21. What do you consider your academic strengths?

22. What do you consider your academic weakness?

23. How do you compare yourself to other students your age? Average__Above_Below__

24. What is your relationship with your parents? Good__ Bad__Neutral__

25. Do you regularly use the counseling services at your present school?

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Created for the Fermilab program sponsored by Fermi National Accelerator Laboratory Education Office, Friends of Fermilab, United States Department of Energy, Illinois State Board of Education, and North Central Regional Technology in Education Consortium which is operated by North Central Regional Educational Laboratory (NCREL).
Author: Minnie L. Robinson (mrobiso@teacher.depaul.edu)
School: Carver High , Chicago, Illinois
Created: October 18, 1997 - Updated: January 10, 1998
URL: /lincon/f97/projects/mrobinson/survey.htm