College Student Retention Survey Template

College Student Retention Survey Template by QuestionPro is designed to get information regarding why a student would leave an education program and the efforts an educational institution needs to put in to retain students. In this sample survey template, questions related to how students have funded their education, what program or course they were enrolled in and what is the overall feedback they would like to share with the institution to improve the services offered. Through this questionnaire, a research wishes to collect information regarding why students leave a certain course of an institution.


You are invited to participate in our College Student Retention Survey. The purpose of this questionnaire is to get your feedback regarding the overall experience you had at our institution and the factors that determined you to leave the education program. The completion will take approximately 15 minutes.

Please, take some time to reflect on each question addressed and try to be as sincere as possible. Your answers will remain confidential and they will be only used in finding ways to improve our educational services in the future. 

Thank you for your cooperation!
* Your University's name:
* Major or Concentration:
* The class level you were when you decided to leave the program:
Freshman (Undergrad)
Sophomore (Undergrad)
Junior (Undergrad)
Senior (Undergrad)
Graduate student
* Your status as a student was:
* Your gender is:
Other / I prefer not to respond
* Your year of birth is (e.g.., 1996):
* Your sources of financing when you attended the university were:
Personal loan
Government Sponsored /Free tuition
Self-financed (from own salary or other)
Parents and/or relatives

* Your main reason for leaving the program at our university?
Health related
Transferred to another program at our university
Transferred to another institution
Forced to withdraw
Voluntary withdrawal (from other reasons)
* If you had withdrawn voluntary, which were the most important reasons for your decision?
I have experienced health related issues
I have accepted a job
I was unable to pay University tuition and fees
My marital or family situation changed my educational goals
I couldn't cope with the stress
I have changed my career and/or educational goals
I wanted a break from my studies

Please rate each of the following statements refering to your experience at our university: 
Strongly Disagree Disagree Neutral Agree Strongly Agree N/A
* The courses were too difficult for me
* The courses weren’t relevant to my career plans
* Teaching methods were poor
* The faculty members weren’t supportive
* My grades dissatisfied me
* The courses schedule didn't fit my program
* Class sizes were too large
* Academic advising was dissatisfying
* The financial aid received was inadequate
* Overall value of the education for the price was dissatisfying
Please share any suggestions that our university could use to provide a better educational experience for students like yourself. (Optional)
* What are your current activities?
Studying at a formal education institution
Studying other than formally
Full-time working
Part-time working
I prefer not to respond

* Do you currently plan to re-enroll at out university?
If you would that a university advisor to contact you to talk about options for you to return to one of our institution's programs, please provide your name and contact information below. (Optional)

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