Annual Single Parent Head of Household Survey

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Local Scholarship Study

Please include today's date, your name, mailing address, email address, and phone number. *

Please include contact information for emergency contact with name, mailing address, email address, and phone number.

Are you willing to report yearly on your academic and work experiences and the impact it has/had on your children? *

What year did you first enroll in college? *

What year did you receive your AAUW CHAR Scholarship? *

How much did you receive as a part of your scholarship? *

What is your degree/certificate goal? *

What degrees/certificates have you earned to date? *

How many semesters did it take to earn your degree/certificate? *

What is your GPA? *

What is your target GPA? *

What is your employment goal? *

Are you currently working in a paying position? *

Yes

How many hours per week do you work? *

What work are you doing? *

Is this your lifetime work goal? *

Yes

Please round your annual income to the next higher $1,000. (e.g. $26,400 = $27,000) *

How many children do you have? *

6 or more

Please provide each child’s age and the maximum education level they have acquired (e.g. 4th grade, college freshman, AA degree, College degree) *

Do you pay for child care? *

Yes

Are you happy with the child care you received? *

Yes

Were you the first in your family to attain a degree? *

Yes

Did/do you struggle with a language barrier? *

Yes

If yes, please explain

Did/do you struggle with a financial barrier? *

Yes

If yes, please explain

Have there been any other challenges you've faced? *

Are you pleased with your progress at this point in time? Please explain your answer. *

What can the school do to help you attain your goals? *

What can AAUW do to help you attain your goals? *

If you have any other comments or concerns that were not addressed in the questions above please list them below.

Please provide a brief summary statement of how the scholarship program has benefited the student outcomes in your life *

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