The lifeline of many institutions are the contributions (large and small), gifts and bequests made by alumni. What has prompted you or would prompt you to become a benefactor of Kentucky State University?

Would you like someone at Kentucky State University to call you to discuss any questions or issues? ☐ Yes ☐ No Name: ___

Phone Number: ___

Email: ___

Best time to contact: ___

Do you have any comments you would like to share to improve the level of service provided to you by Kentucky State University?

What is your class year? (If you have more than one degree, please list in order of obtaining) _____

Are you?

Are you? ☐ Male ☐ Female

African-American or Black

American Indian or Alaskan Native

Asian

Caucasian or White

☐ Interracial

Native Hawaiian or Pacific Islander

□ Other . What is your age range? □ 25 or younger □ 26-35 □ 36-45 □ 46-55 □ 56-65 □ 66-75 □ 75 or older

What is your age range? ☐ 25 or younger ☐ 26-35 ☐ 36-45 ☐ 46-55 ☐ 56-65 ☐ 66-75 ☐ 75 or older

Which of the following best describes your employment status?

Which of the following best describes your employment status?

Employed, working 1-39 hours per week

Employed, working 40 or more hours per week

☐ Not employed, seeking work

Not employed, full-time student

Semi-Retired

☐ Retired

Disabled

Other

Are you a first-generation college graduate? ___ ☐ Yes ☐ No