Degree Consulting Services

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Our Questionnaire

This Questionnaire can be used in several ways:

Print and mail to:

DCS, P.O. Box 3533, Santa Rosa, CA 95402

Express: DCS, 538 Blackstone Ct., Santa Rosa, CA 95409

Email information and answers to degrees@sonic.net

A paper Questionnaire can be mailed or faxed to you.

Telephone and we can fill it out for you.

Add lines as needed, and a letter, resume, transcript copies, or documents, as you wish. All or portions of your information can be emailed, faxed, mailed, or telephoned.

THE MORE WE KNOW, THE BETTER WE CAN HELP YOU.

ALL INFORMATION IS STRICTLY CONFIDENTIAL.

Today's date_______________________

Mr./Ms./Mrs./Miss __________________________________________

Street Address/Box _________________________________________

City __________________________ State/Province ____________

Country ____________________ Postal Code __________________

Telephone ______________________ Fax ______________________

Email ____________________________________

Age ____ Birthplace _____________________

RECENT EMPLOYMENT

Current job (employer, responsibilities, how long):

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Previous employment:

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EDUCATIONAL BACKGROUND

High School Diploma (yes/no)_____

Colleges and universities attended:

Institutions Major(s) Credits Degree/Years

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Other education, training, and learning experiences

(e.g. professional, company, military, licenses, languages, independent studies):

__________________________________________________________

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COUNSELING SPECIFICATIONS

Which degrees do you want to complete?

Associates ___ Bachelors ___ Certificate ___

Masters ___ Doctorate ___

In which field of study do you want your degree(s)?

First choice _____________________________________________

Second choice ___________________________________________

Beyond these choices, what are your areas of special interest?

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The degree(s) must be nonresidential or have the least possible time on campus. (yes/no) _____

I could spend ___ days or _____ weeks on the campus.

Degree must be from regionally accredited (US) or non-US equivalent institutions. ___

Degrees could be from a reputable unaccredited university. ___

PREFERRED LEARNING METHODS

Preferred learning methods and formats for earning credits for an Associates and Bachelors degree:

Assessment of experience ___ Equivalency exams ___

Online courses and contacts ___ Correspondence courses ___

Self-designed courses ___

Short seminars on campus or site ___

For Bachelors: Senior project or thesis ___

Preferred learning methods and formats for a Masters and Doctorate:

Thesis or dissertation ___ Independent study courses___

Online courses ___ Short seminars on campus or site ___

MORE ABOUT YOUR INTERESTS

Why do you want the degree? For example: career advancement, expand knowledge and skills, personal satisfaction, higher income, job security.

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Which distance learning degree programs have you identified? What interests you about each? What do you not like?

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What would you like to be doing five years from now?

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Relate anything else that is relevant about yourself:

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FEE INFORMATION

The fee for a year of consulting is $90. We accept a personal check (US only), check with US branch address, VISA, MasterCard and Discover Card, and money orders. Your initial consulting letter with catalog excerpts usually takes 10 days to finish and airmail. For an expedited response, with initial package completed and mailed within two days, add $25.

VISA/MasterCard/Discover Card Information:

Card Number: _______________________________________________

Expiration Date: _____________ Amount: $____

Signature: _________________________ ____________