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ACADEMIC CREDIT QUESTIONNAIRE

For the adult of maturity and achievement who wants to work toward on off-campus university degree...

Please fill out this form

Today, self-motivate adults who cannot interrupt their work to pursue their education on campus can earn a university degree. This degree gives credit for life achievement, seminar attendance, travel and for our online, self-study program, Educate Yourself for Tomorrow. Whether you pursue a BA, MA, or Ph.D., your degree will be fully recognized by major universities, government agencies and corporations.

The first step is to fill out the following questionnaire as fully as you can. When we receive your questionnaire, we will e-mail you information about the university most suitable for you to pursue your degree program, along with an application and fee schedule.

If you decide to enroll in a degree program, we will act as your mentor for your Educate Yourself for Tomorrow course of study. We will evaluate your responses to the questions following each guide. You can earn additional credits by submitting your own essay on each topic. When you complete the course, we will certify to the university the academic credits you have earned. (And, if you wish, we can act as your mentor throughout your entire degree program.)

Now, please continue, complete your questionnaire and submit it. It will start you on your way to an exciting educational accomplishment.

First Name:   Last Name:  

Street Address:  

City:   State/Province:   Postal Code:  

Country:  

Email Address:  

Birthplace:  

Sex: Male Female

Age:

Marital Status: Single Married Divorced/separated Widowed


Children (number, ages)


Veteran? Yes No


Benefits remaining? Yes No


Any physical handicaps that might affect the learning process? Yes No


Current job (employer, duties, how long):


Previous employment (employers, duties, how long):


Educational Background:

High School Diploma? Yes No

If no, last grade completed:

Traditional (residential) colleges or universities attended:
(Include school, location, major, number of units earned, degree)


Non Traditional, Alternative or Correspondence Schools attended, degrees received:


Other learning experiences (military, travel, volunteer work, religious study, aviation, other languages spoken, etc.):


Which degree are you interested in earning? (Check only one or two, please)
Associates
Bachelors
Masters
Doctorate

What is your field of study or special interest?


In which field(s) would you prefer the degree? (Degree programs may not be available in all disciplines.)

First choice: Second choice:


The degree must be completely done through online study.

I could spend 1 to 2 weeks on a campus
Campus near my home
Anywhere in U.S.
Within 500 miles

I could spend 3 to 6 weeks on a campus
Campus near my home
Anywhere in U.S.
Within 500 miles

Which of these statements best describes the kind of degree you are looking for?
Degree must be from school fully accredited by accrediting agency recognized by U.S. government.
Degree could come from school non-accredited but state authorized and highly regarded.


Why do you wish to earn the degree?
job or salary advancement
qualify for new job
self-satisfaction
other


What is the longest period of time you would consider spending to earn the degree?
1-2 months
2-6 months
6-12 months
12-18 months
over 18


Are you enrolled in any degree programs now? Describe:


Do you have catalogues or information from schools that interest you? Which ones?


What would you (realistically) like to be doing five years from today?


Please relate anything else you think may be relevant:


From what website or other source did you learn about Educate Yourself for Tomorrow?

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