STUDENT INFORMATION:

Graduate Name:

Graduate Street Address:   City:  

State: AlabamaAlaska ArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisiana MaineMarylandMassachusettsMichiganMinnesotaMississippiMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth Carolina North DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashington West VirginiaWisconsin Wyoming Zip Code:  

Email Address:   Phone Number:  

Gender: MaleFemale  Ethnicity: WhiteNative Hawaiian or Other Pacific IslanderHispanic or LatinoBlack or African AmericanAsianAmerican Indian or Alaska NativePrefer Not to Say 

Program: Associate Project ManagementBusiness AdministrationClinical Medical Assistant Cloud Computing SpecialistCybersecurity AnalystDental AssistantEKG Technician Electronic Health RecordsHuman Resource SpecialistIT HelpDesk TechnicianIT Network TechnicianIT Security SpecialistMedical Administrative AssistantMedical Administrative Assistant with Business AdministrationMedical Administrative Assistant with Electronic Health RecordsMedical Administrative Assistant with Electronic Health Records and Medical Billing & CodingMedical Administrative Assistant with Medical Billing & CodingMedical Billing & CodingMicrosoft 365 Certified: Modern Desktop Administrator AssociatePatient Care TechnicianPayroll SpecialistPC TechnicianPersonal TrainerPharmacy Technician Phlebotomy TechnicianPhlebotomy-Cardio TechnicianSurgical Technologist 

Start Date

Graduation Date

Instructor(s):  

PAYMENT INFORMATION:

Method of Payment: CashCredit CardCheckVive FinancingParamount FinancingClimb FinancingIHFPath 2 PromiseUnited WayMoney OrderWIOACareer SourceCampbell StrongMYCAAMeritizeMiaShareTradeupLeifAscent 

PLACEMENT CONFIRMATION:

Please put any type of Employment, whether in-field or out-of-field. If not employed, please put "Not Employed" in Required Boxes.

Place of Employment:  

Name of Employer/Contact Person:  

Business Street Address:  

City:    State: StateAlabamaAlaska ArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisiana MaineMarylandMassachusettsMichiganMinnesotaMississippiMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth Carolina North DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashington West VirginiaWisconsin Wyoming   Zip Code:  

Business Phone Number:   Business Fax Number:  

Business E-Mail:  

Date of Employment:

Job Title:  

Please List Four Job Duties:

Job Duty #1:  

Job Duty #2:  

Job Duty #3:  

Job Duty #4:  

Wage Per Hour:    Total Hours per Week:  

Does the Student Need Placement Assistance? YesNo 

GRADUATE SURVEY:

Please respond to the following:
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Select the rating from the dropdown that indicates the extent to which you agree with each statement. Please do not skip any item. Any question scored less than 3 requires explanation or if you wish to leave additional comments, please describe in the box below the statement. All graduates must complete this survey to receive their transcript and certificates.

5 = Strongly Agree 4 = Agree 3 = Acceptable 2 = Disagree 1 = Strongly Disagree

General Evaluation

I was informed that I would receive a program certificate of completion after completing all requirements. 12345 

The classroom/clinical portion of the program adequately prepared me for employment. 12345 

The clinical externship portion of the program adequately prepared me for employment, if applicable. 12345 

Upon completion of my classroom training, an externship site was available to me, if applicable. 12345 

Admissions staff are knowledgeable in programs and provide courteous service. 12345 

The course content is consistent with the program’s goals. 12345 

I would recommend this program/institution to friends or family members. 12345 

Instructor Evaluation

My instructors were knowledgeable in the subject matter and relayed this knowledge to the class. 12345 

The instructor’s development and presentation of material is consistent with the syllabus. 12345 

The instructor explains concepts clearly and in an organized manner. 12345 

The instructor encourages group interaction and critical thinking (if applicable). 12345 

The instructor provided adequate feedback in a timely manner. 12345 

STUDENT SERVICE LINKS

I, , acknowledge upon TMIKY Online receiving this Graduate Survey my Transcript(s) and Certification(s) will be delivered to me. I acknowledge I have had the opportunity to express my thoughts in writing concerning my education with TMIKY Online. I also authorize and give consent to TMIKY Online to contact my employer and obtain employment verification needed to maintain licensure requirements and placement tracking records. 

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Document name: Exit Interview

Unique Document ID: 76ee7463454c65fa85bf06dfc59ef2dd3a494d47

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Timestamp	Audit
July 26, 2022 11:47 am EDT	Exit Interview Uploaded by Cassie Black - [email protected] IP 99.190.9.234
July 27, 2022 9:45 am EDT	CCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
September 22, 2022 8:41 am EDT	CCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
September 22, 2022 8:42 am EDT	CCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234

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