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Last Name
First Name
UVA User ID
Current Role
Current Department
Managers Name
Do you currently work
Full Time
Part-time
Wage
Are you interested in a career in nursing?
Yes
No
Thinking about it...but need to learn more
What best describes your interest
RN-Associate of Nursing Degree from Piedmont Virginia Community College
RN-Bachelor of Nursing Degree from UVA SON or another BSN Program
I have a Bachelor Degree in something else--but want to be a RN and need know options
I have my RN and Bachelor's in Nursing-I want to advance to Master's Degree or Nurse Practitioner
If none of these apply, please tell us more
Have you completed any prerequisite classes for entry into the Piedmont Virginia Community College (PVCC) Nursing Program?
Yes
No
Currently enrolled--but not completed
Please list any courses you have completed
Are you currently enrolled in the PVCC Nursing Program in either your first or second year?
No
Yes-year 1
Yes-year 2
Have you applied for entry into the PVCC Nursing Program starting in fall semester 2024?
Yes
No
Are you interested in becoming a RN through PVCC Nursing Program
I'm thinking about it, but need to learn more
Yes, but I'm not sure how to get started
Yes-I'm currently taking classes
Are you currently a LPN who wishes to get your RN?
Yes
No
How would you best like to receive information about the EWYL Nursing Program
Webex virtual meeting
Live Session
Written Materials
Other
What day of week is best for informational sessions
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What time of day is best for informational sessions
Morning
Middle of the Day
Afternoon
Evening
Your best time
When you consider returning to college to get your degree what are the biggest barriers you face. Please choose all that apply
Work schedule
Not enough hours in the day
Funds to afford tuition and related expenses
The need to work 40 hours...can't do additional hours
Anxiety
Fear of failure
Family obligations
Family support
Support of manager
Class times don't work for me
Other-please describe
Please share comments or questions
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