AFRICAN AMERICAN MALE LEADERSHIP INITIATIVE
SurveyMethods is unable to process your internet requests because you have Javascript disabled on your browser. You need to enable Javascript to use this website. Please
click here
to view instructions on how to enable Javascript on your browser.
NOTE: Once you enable Javascript you must save your browser settings, close and reopen any browser windows for your settings to take effect.
Page
1
:
Untitled
Page
1
of
1
*
1.
Student Information
Last Name
First Name
Student ID #
Address
City
Zip Code
Contact Phone
Email
Major
Campus
GPA - minimum 2.0 is required
2.
Why do you want to be involved in the African American Male Leadership Initiative?
Remaining characters: 500
3.
How can Midlands Technical College assist you in becoming a leader?
Remaining characters: 500
4.
Midlands Technical College’s motto is, “You can get anywhere from here.” What do you see as your role and how can the college help in the process?
Remaining characters: 500
*
5.
Check all items you would like to participate in:
Workshops
Community Service
Educational Trips
Job Shadowing
If other, please specify
*
6.
Select any challenges you believe may prevent you from completing your educational goals:
Finances
Time Management
Study Habits
Lack of Support
If other, please specify
Page
1
of
1