1. Marital Status:
___Single
___Married
___Divorced
___Widowed
2. Your Occupation: _____________________
City and State in which you live: ____________________
City and State in which you work: ____________________
3. Age: ___Under 21 ___21-30 ___31-40 ___41-50
___Over 50
4. Gender: ___Male ___Female
5. Highest Level of Education Completed:
___High School Graduate
___Associate's Degree
___Bachelor's Degree
___Master's Degree
___Ph.D./Ed.D.
___Other
6. Your area of study: _________________________
Are you currently studying toward a degree? __Yes __No
7. Do you own computer? __Yes __No
If yes, what type of computer?
___IBM PC Compatible
___Macintosh
___Other
Do you have modem? ___Yes ___No
If yes, what speed(bps) is your modem?
___2,400
___4,800
___9,600
___14,400
___28,800
___Over 28,800
___Don't know
8. How are you connected to a university computer system?
___Direct LAN connection
___Local call(to modem pool)
___Long distance call(to modem pool)
___Internet S.P.(telnet using PPP or SLIP)
___Internet S.P.(serial connection to menu)
9. What is your monthly connection cost?
___under $10
___$10 to $19.99
___$20 to $29.99
___$30 to $39.99
___$40 to $49.99
___$50 and over
10. Which of the following course expenses are paid by your
employer?
___Tuition
___Books
___Other Materials
___Release Time
___Other (please specify): _____________________
11. What are your purposes for taking computer-based distance
education courses?
___License or relicensure
___Career promotion or advancement
___Improve job performance
___Learning/Education Value
___Other (Please Specify): ____________________
12. Please identify your level of skills in the following
applications? Please rate the skills as follows:
5 = 90% and over of times successful in operation
4 = About 75% of times successful in operation
3 = About 50% of times successful in operation
2 = About 25% of times successful in operation
1 = Don't know
5 4 3 2 1
Electronic Mail(e-mail).... ___ ___ ___ ___ ___
File Transfer Protocol(FTP).___ ___ ___ ___ ___
WORLD-WIDE WEB(WWW)........ ___ ___ ___ ___ ___
GOPHER..................... ___ ___ ___ ___ ___
BULLETIN BOARD............. ___ ___ ___ ___ ___
(VAXNotes, Usenet News,.)
CHAT....................... ___ ___ ___ ___ ___
(IRC, America online,...)
TELNET..................... ___ ___ ___ ___ ___
13. Who do you contact for help with computer problems? (Please
check all that apply).
___Instructor
___Friend
___Classmate
___Family Member
___University Expert
___Vendor/Publisher
___Other (Please specify): _____________________
14. Please answer the following questions concerning the most
recent computer-based course you have taken at the university
by checking YES or NO.
Yes No
Did you receive adequate documentation for
the utilization of computer applications from
the university where you are taking
computer-based course? ___ ___
Did you have any computer experience before you
took auniversity-level computer-based course? ___ ___
Was this the first computer-based course
you have taken? ___ ___
Do you plan to enroll in more computer-based
distancelearning courses at the univ. level? ___ ___
Would you recommend computer-based courses to
others? ___ ___
Have you enrolled in any on-campus courses? ___ ___
Do you think it worthwile to take distance
learning courses by computer only? ___ ___
Do you have interaction with classmates by
computer? ___ ___
Do you share ideas and problems with
classmates by computer? ___ ___
Do you have group projects or discussions
with other classmates by computer? ___ ___
15. Please answer the following items by checking
the appropriate space.
Excel Good Fair Poor Not accep
How do you rate the
documentation for accessing
computer resourses that the
university gave you? ____ ____ ____ ____ ____
How do you rate your
instructor's availability
via the computer? ____ ____ ____ ____ ____
How do you rate your
instructor's comptency in
helping you with computer-
related questions in this
course? ____ ____ ____ ____ ____
How do you rate the
university support provided
in cases of unexpected
technical problems? ____ ____ ____ ____ ____
How do you rate the Internet
provider's support in cases
of communications problems? ____ ____ ____ ____ ____
How do you rate the content
and materials of the course? ____ ____ ____ ____ ____
How do you rate the overall
system of computer-based
distance learning based on
your experience? ____ ____ ____ ____ ____
16. What are your main CONCERNS in computer-based distance education?
5 = Crucial
4 = Very important
3 = Impoortant
2 = Somewhat important
1 = Of little importance
___ Studnts/teacher communication
___ Teacher's computer competency
___ Student's computer competency
___ Support group in university
___ Personal interaction in the group
___ Student's access to campus resources
___ Computer training programs by university
___ Connection cost
___ Computer cost
___ Other (please specify):__________________
17. What do you see as major ADVANTAGES of computer-based
classes in Indiana?
5 = Very important
4 = Important
3 = Somewhat important
2 = Not important
1 = Don't know
___ New opportunity for adult education
___ Student-centered education
___ Faculty roles as facilitator
___ Cost efficiency
___ Flexibility of time and place
___ Variety of learning resources
18. Additional comments: ______________________________________
_______________________________________________________________
1. At what univ. or college do you teach? __________________
2. What depart. is offering this class?_______________
3. How many semesters have you taught computer-based
classes? ____
4. Which of the following tools and applications do you use in your computer-based classes?
_____ E-mail
_____ World Wide Web
_____ FTP
_____ Gopher
_____ Bulletinboard (BBS)
_____ Other (please specify): ____________________
5. Please respond to the following questions by checking the appropriate response.
How would you rate your competency in the utilization of computers as a communication tool(e-mail, Bulletinboard)?
____ Excellent
____ Competent
____ Good
____ Acceptable
____ Not Competent
How would you rate your competency in the utilization of computer as access to resources (library, internet applications,..)?
____ Excellent
____ Competent
____ Good
____ Acceptable
____ Not Competent
How would you rate your computer competency in the designing computer educational applications in the form of case study,simulation,..?
____ Excellent
____ Competent
____ Good
____ Acceptable
____ Not Competent
How would you rate your students' competency in the utilization of computer's resources and applications?
____ Excellent
____ Competent
____ Good
____ Acceptable
____ Not Competent
6. Please respond to the following questions by checking either YES or NO.
Have you had training in computer connection YES NO
(using Kermit or Internet Service Provider) to
campus resources? ____ ____
Have you had training in the utilization of
computer's resources and applications? ____ ____
Have you had special training for this new
pedagogical method (computer-based distance
education)? ____ ____
Do your students in the computer-based classes
have any on-campus training or orientation in
connection,communication,and access to computer
resources? ____ ____
Do you think universities in Indiana are ready
to offer computer-based classes? ____ ____
Do you think faculty are ready to teach
computer-based classes? ____ ____
Do you think students are ready for
computer-based classes? ____ ____
When problems arise, do you have technical
support? ____ ____
Do you think the quality of computer-based classes
are the same as on-campus classes? ____ ____
Do you think learning opportunities of students
in the computer-based classes are the same as
on-campus classes? ____ ____
If NO, what are the main reasons? (check all that apply)
_____ Lack of lecture
_____ Lack of group cohension
_____ Lack of direct access to teacher
_____ Lack of team work
_____ Lack of class discussion
_____ This new way of learning
_____ Other (pleae specify): ________________________
7. How well prepared were you to teach your first
computer-based class?
___Well prepared
___Adequately prepared
___Not well prepared
___Not prepared
8. If this is not your first computer-based class,
how well prepared are you now to teach computer-based classes?
___Well prepared
___Adequately prepared
___Not well prepared
___Not prepared
9. What percentage of your students are capable of succeeding in
computer-based classes?
___More than 90%
___About 75%
___About 50%
___About 25%
___Less than 10%
10. What are your main concerns in computer-based distance
education?
5 = Crucial
4 = Very important
3 = Important
2 = Somewhat important
1 = Of little importance
___ Students/teacher communication
___ Teacher's computer competency
___ Student's computer competency
___ Support group in university
___ Personal interaction in the group
___ Student's access to campus resources
___ Computer training programs by university
___ Connection cost
___ Computer cost
___ Other (please specify): _______________
11. What do you see as major advantages of computer-based classes in Indiana?
5 = Very important
4 = Important
3 = Somewhat important
2 = Not important
1 = Don't know
___ New opportunity for adult education
___ Student-centered education
___ Faculty roles as facilitator
___ Cost efficiency
___ Flexibility of time and place
___ Variety of learning resources
12. Additional comments: ________________________________________ _________________________________________________________________