Out 2 Lunch Assessment

Thank you for participating in the Out-to-Lunch program. This assessment is intended only for students who have completed an Out-to-Lunch dialogue. Completion of this assessment will establish record of your participation in the Out-to-Lunch program.

Contact & Demographic Questions

Student Name:


Email Address:


CWID:


Gender:


Ethnicity:


Are you a member of an IFC, NPC, NPHC, or UGC organization?:

Yes

No

Are you in Honors College?:

Yes

No


What is your classification?:


Do you live on or off of campus:

On campus

Off campus


Faculty/Staff member's full name:


Faculty/Staff member's email address:


Faculty/Staff Title or Position:


Date of Out 2 Lunch Experience:


Location of Out 2 Lunch Experience:


Amount Spent for Faculty/Staff:


Did you use a guest meal?:

Yes

No

O2L Experience Questions

Please reflect on your Out 2 Lunch dialogue and then rate the following statements on a scale of 1 to 5 (1 = Strongly Disagree, 5 = Strongly Agree):

I used my Out 2 Lunch dialogue to examine my academic and/or career goals.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

I used my Out 2 Lunch dialogue to develop or enhance my relationship with my faculty/staff member.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

I used my Out 2 Lunch dialogue to become more comfortable communicating with my faculty/staff member.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

Additional Comments (about the dialogue)

O2L Impact Questions

Please reflect on your Out 2 Lunch dialogue and then rate the following statements on a scale of 1 to 5 (1 = Strongly Disagree, 5 = Strongly Agree):

After Out 2 Lunch, I am more likely to communicate with my Faculty/Staff member about his or her department/position.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

After Out 2 Lunch, I am more likely to communicate with my faculty/staff member about my academic goals.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

After Out 2 Lunch, I am more likely to approach other UA Faculty/Staff members in the future.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

After Out 2 Lunch, I am more likely to contact a UA Faculty/Staff member about actively engaging in the UA community.

5
Strongly Agree

4

3
Neutral

2

1
Strongly Disagree

Additional Comments