UNIVERSITY OF NEW MEXICO GALLUP BRANCH

APPLICATION FOR GRADUATION
 (please print)

   
Name
Social Security No.
   
Address
Home/Work Message Number

I am applying for:
Associates of Arts Degree
Associate of Science Degree
Certificate
Associate of Applied Science Degree
   
My Major is
(for multiple degrees, list each one)


I plan to graduate at the end of the _________________ Semester, _______________ (year).

Have you transferred any credits from another college towards this degree?
Yes No

Besides completing the academic requirements of your program, there are three additional tasks required for graduation:

Complete the survey on Service Learning at UNM-Gallup
Complete the survey on "Quality of Life"
Take the Academic Profile general education test (2 year degree candidates only)

The activities listed above are part of the UNM-Gallup's Student Outcomes Assessment Plan, which is designated to measure student achievement in general education and all programs, as well as to not changes in student attitudes and values. While these assessment activities are required, the results willnot be posted as part of a student's official record. Scores on tests and opinions expressed in surveys will be reported only in group form, not by individual. There is no minimum score required on the Academic Profile test, just try to do your best. Two-year degree candidates will be notified about the testing times for the Academic Profile (in November for Fall semester, and April for Spring/Summer semester graduates). The Academic Profile test will take about one hour.

   
Student's Signature
Date Signed


PLEASE COMPLETE THE FOLLOWING SURVEYS, AND RETURN THIS FORM AND THE SURVEYS TO YOUR ADVISOR.

FOR OFFICE USE ONLY

Student's Name: ______________________________________________________

Advisor Name: ______________________________________________________

Degree Audit completed on ___________________ (date).

Cleared for graduation pending completion of current semester.

Advisor's Signature: ___________________________________________

Date: ___________________________________________________________

Copy of graduation application was forwarded to the Registrar's Assistant

Registrar's Assistant's Signature: _______________________________________________________

Date: ___________________________________________________





UNM-Gallup Quality of Life Questionnaire for Exiting Students

   
Name
Social Security No.


My main educational goal at UNM-Gallup has been: (check the one that fits you best)
I want to get a Two-Year Degree or Certificate, and then get a job in that field.
I want to go on from UNM-Gallup and transfer to a four-year program
I have been taking courses for my own enjoyment (I'm a life long learner)
Other __________________________________________________
As part of the ongoing assessment of student outcomes at UNM-Gallup, we want to know about your personal ideas about "quality of life", and what effect your time at UNM-Gallup has had on your ideas. Please check the box that best answers for you the following questions that relate to quality of life:
  1. How would you rate your current ability to earn a living?
  2. very low somewhat low moderate somewhat high very high
  3. How would you rate your current community participation?
  4. very low somewhat low moderate somewhat high very high
  5. How would you rate the quality of your relationships with others?
  6. very low somewhat low moderate somewhat high very high
  7. How would you rate your communication skills?
  8. very low somewhat low moderate somewhat high very high
  9. How would you rate your problem solving skills?
  10. very low somewhat low moderate somewhat high very high
  11. How would you rate your feelings about yourself?
  12. very low somewhat low moderate somewhat high very high
  13. How would you rate your comfort with your spiritual life?
  14. very low somewhat low moderate somewhat high very high
  15. How would you rate your knowledge of yourself?
  16. very low somewhat low moderate somewhat high very high
  17. How would you rate the quality of your relationship to nature and the earth?
  18. very low somewhat low moderate somewhat high very high
  19. To what degree is helping others a part of your life?
  20. very low somewhat low moderate somewhat high very high
  21. How would you rate the quality of the way you feel physcially?
  22. very low somewhat low moderate somewhat high very high
  23. How would you rate your opportunities to improve your health and fitness?
  24. very low somewhat low moderate somewhat high very high
  25. How would you rate your opportunities to have beauty in your life?
  26. very low somewhat low moderate somewhat high very high
  27. How would you rate your ability to achieve your goals?
  28. very low somewhat low moderate somewhat high very high
  29. What other things are important to you, and how would you rate yourself on them?
    Item of importance__________________________________________________________
    very low somewhat low moderate somewhat high very high
    Item of importance _______________________________________________________
  30. very low somewhat low moderate somewhat high very high
Please take one or more of the items you rated above, or others that occur to you, and briefly explain how it relates to your current vision of "quality of life".














Given how you describe quality of life, how has your time at UNM-Gallup helped you to develop or improve your quality of life?














THANK YOU FOR YOUR INPUT!

Please return this survey to your advisor, along with your application for graduation.





UNM-Gallup Community Service/Service Learning Exit Survey

Congratulations! You are about to graduate. Before your go, UNM-Gallup would like to get some feedback from you about our Service Learning opportunities. Service Learning is an experiential learning method in which the student combines community service with academic coursework.

Please take a few minutes to answer the following questions that relate to Service Learning at UNM-Gallup.

   
Name
Social Security No.


Have you ever participated in Service Learning?
Yes No

Have you participated in Service Learning while at UNM-Gallup? Yes No
If so, in what activities? ________________________________________________
Did you ever visit the Center for Service Learning?
Yes No

Was Service Learning a required or optional part of any of your courses? Yes No
If so, which courses? ________________________________________________
If you did not participate in Service Learning while at UNM-Gallup, why not?
I have never heard about Service Learning at UNM-Gallup
I have heard about Service Learning, but I did not want to participate
I have heard about Service Learning, but I did not have time to participate
None of my classes had a Service Learning component
Other ___________________________________________________



If you did participate in Service Learning while at UNM-Gallup, please answer the next 5 questions:

What were the benefits of participating in Service Learning at UNM-Gallup, and what did you gain from your Service Learning Experience?









Was Service Learning worth the time and effort you had put into it?
Yes No
Please explain:




Did your Service Learning experience change your attitude towards helping your community?
Yes No
Please explain:




Has Service Leaning been helpful in your educational and/or career decision making?
Yes No
Please explain:




Would you enroll in another course which included Service Learning?
Yes No
Please explain:








How could the Service Learning opportunities offered at UNM-Gallup be improved or better integrated into existing courses?









In this section you will find a number of statements. For each statement, a scale from 5 to 1 is provided, with 5 representing one extreme of agreement and 1 extreme disagreement. For each statement, circle the number from 5 to 1 that indicates the extent to which you agree or disagree with the statement. There are no right or wrong answers. Please answer all of the items:

5 = I Strongly Agree 4 = I Slightly Agree 3 = I am Neutral or Don't Know 2 = I Slightly Disagree 1 = I Strongly Disagree
  1. All individuals have a responsibility to participate in community service activities throughout life.
  2. 5 4 3 2 1

  3. Community service is valuable for the recipients of the service.
  4. 5 4 3 2 1

  5. Participation in community service offers a valuable learning experience for the service provider.
  6. 5 4 3 2 1

  7. Participating in community service activities is a way to help me achieve my personal goals.
  8. 5 4 3 2 1

  9. Participation in community service is valuable for our society.
  10. 5 4 3 2 1

  11. I would be likely to encourage my friends and family to participate in community service.
  12. 5 4 3 2 1

  13. By participating in community service activities I can make a difference in society.
  14. 5 4 3 2 1

  15. Participating in community service activities is a way to help me achieve my career goal.
  16. 5 4 3 2 1

  17. Providing community service is a way to develop a better understanding of the people receiving the services.
  18. 5 4 3 2 1

  19. Participating in community service activities is a way to help me achieve my educational goals.
  20. 5 4 3 2 1

  21. I would only participate in community service if it was required.
  22. 5 4 3 2 1

  23. People should encourage each other to participate in community service.
  24. 5 4 3 2 1

  25. Participation in community service develops valuable life skills.
  26. 5 4 3 2 1

  27. Parents should encourage their children to become involved in community service activities.
  28. 5 4 3 2 1

  29. There should be more opportunity to complete college studies with community service through service learning.
  30. 5 4 3 2 1

Thank you for participating in this important survey!