Name : * Postal Code : Telephone : * Email Address : * Verify Email Address : * Gender : Male Female * Age Range : 15 to 18 years 19 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 years and older * Where Did You Hear About This Keyin College Contest? : Television Newspaper Radio Internet Keyin Graduate Keyin Student Keyin Employee Guidance Counsellor School Visit Friend * Highest Level of Education Attained : High School - Grade 9 or less High School – Grade 10 High School – Grade 11 High School – Grade 12 High School – Graduate Trades Certificate College Diploma University Degree University Post Graduate Other * Do you plan on furthering your education in the next 3 years? : Yes No If YES, at what level are you planning to further your studies? : High School High School Upgrading Trades Certificate College Diploma University Degree University Post Graduate Undecided Other If NO, what is your current status of employment? : Full-time Part-time Casual Homemaker Unemployed Retired Please select your program of interest : Adult Basic EducationAquacultureBusiness ManagementBusiness Management/Human Resource ManagementCareer PreparationComputer StudiesContinuing Education DivisionCorporate TrainingDental Assisting IIEarly Childhood EducationEstheticsFuneral Director and EmbalmerGeographic Information SystemsHairstylistHome Support WorkerHospitality ManagementHuman Resource Management Information Systems Security SpecialistInsulator (Heat and Frost)Life Skills DevelopmentMedical TranscriptionistNetwork Design and ManagementOccupational Health and SafetyOffice AdministrationOffice Technology EnhancementParalegal Administration *PC Internet Programming PC RepairPersonal Care Attendant/Home Support WorkerPharmacy TechnicianSales and Service AssociateSpeech Language Pathology AssistantSpell Read P.A.T. TestTherapeutic RecreationTravel and TourismOther * If 'Other' Please Specify : Campus Location : CarbonearClarenvilleFortune Adult Learning CentreGanderGrand Falls-WindsorLamaline Adult Learning CentreLewisporte Adult Learning CentreMarystownSt. John'sStephenville Adult Learning Centre * Promotional Code : (Optional) * denotes a required field. Thank you for taking the time to complete our survey and best of luck in the contest! One entry per email address. Contest ends: Friday, June 29th, 2007. Participants must be 15 years of age or older and possess a valid email address to be eligible. Note: At Keyin College we respect your privacy and value our relationship with you. Your personal information will be protected, will never be sold, and will be used only by Keyin College. Our goal is to enhance your product and service experience with us. By submitting this personal information to us, you are consenting to its use and disclosure for the following purposes: Providing you with general marketing, product, and service opportunities. Conducting market analysis. Maintaining the accuracy of our records to respond to your inquiries and otherwise manage our relationship with you.