AVRTS LPN Program
Evening Program Interest Survey

1) AVRTS currently offers a full time day program over 10 months.
If a 2 year part-time evening program was offered would you prefer it
to the current program?

Yes
No

2) How many hours do you plan to work while attending the program?
(select one)

40 hrs/week or more
30-39 hrs/week
20-29 hrs/week
Less than 20 hrs/week
Unemployed

3) What is your gender?

Male
Female

4) What is your current age? (select one)

Less than 18
18 to 29
30 to 39
40 to 49
50 or older