E-Learning: Student Information example

This is an example E-Learning: Student Information survey. This survey includes questions like:

We hope this will help you create your own E-Learning: Student Information survey. We have not tested the validitiy or reliability of this survey. However, you may use this as a starting point to help your own survey instrument. Feel free to change and edit any of our survey templates to help you get started.

Sign up to start building your survey!

1) Student Name
2) Birthdate (please enter in format 01/01/1964)
3) Age
4) What is the highest level of education you have completed?
5) What is your first language (for instance the language you speak at home)?
6) How many previous web-based learning courses have you completed?
7) What is your main reason for taking this course?
  • Enrichment
  • Job Requirement
  • Credit Toward Degree Requirement
  • Continuing Education
  • Other:
8) Where will you be doing the majority of your coursework?
9) How will you be connecting to the internet to participate in this course?
  • 28k modem
  • 56k modem
  • Lan Connection
  • DSL
  • Cable Modem
  • Don't Know
  • Other:
10) What type of web browser will you be using to access the course?
  • Internet Explorer
  • Netscape Navigator
  • AOL
  • Don't Know
  • Other:
11) What, if any, special needs do you have for participation in this e-learning course?
12) What are your expectations for this course?
Sign up to start building your survey!