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Hello: We are inviting you to participate in our survey, the purpose of which is to collect demographic information from participants in THR Academic Programs. This data will be provided to accreditation organizations and other necessary parties, such as granting sources, etc. This information will also help future program planning to better design elements to meet student needs. Your input is a critical element in the continuous improvement process.
Your participation is completely voluntary and the information will not be shared as individual data but only as grouped data. All information shared on this form will be coded and remain confidential, and will be used only for program planning purposes.
Thank you very much for your time and support. Please start the survey now by clicking on the Continue button below.
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In what year have you enrolled? |
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In what term have you enrolled? |
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In what THR facility are you currently employed? |
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In what program have you enrolled? |
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Please note: the following question is mandatory. All international students must have a United States Work Visa or appropriate documentation in order to participate in THR Academic Programs. If you do not have a Work Visa you must notify the Director of Clinical Education & Academic Partnerships immediately.
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The following information is optional and will remain strictly confidential. Information you provide will only be reported as aggregated or grouped data. Some of this information is being requested to ensure EEOC compliance and/or to ensure recommendations for proper accommodations. |
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American Indian or Alaskan Native (not Hispanic or Latino; a person having origins in any of the original people of North America, and who maintains cultural identification through community recognition or tribal affiliation)
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Asian (not Hispanic or Latino; a person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Philippine Islands)
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Black or African American (not Hispanic or Latino; a person having origin in any of the black racial groups of Africa)
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Hispanic or Latino (a person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race)
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Native Hawaiian or Other Pacific Islander (not Hispanic or Latino; a person having origins in any of the original peoples of the Hawaiian Islands, Guam, Samoa, Fiji, Tonga, or other Pacific Islands)
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White (not Hispanic or Latino; a person having origins in any of the original peoples of Europe, North Africa or the Middle East)
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English Language Proficiency
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This question is asked to monitor accommodations for program participants with disabilities.
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Do you have a documented disability? |
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Highest Level Formal Education Completed |
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Degree-Granting Institution |
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How did you hear about the THR Academic Programs? |
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Which nursing specialization interests you the most? |
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In which of the following areas do you need assistance? (Check all that apply) |
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What kind of work do you currently perform? |
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| Other improvements that would assist you as a student/intern: | | |
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