Dear Registrant: Below is a two-part registration form. Please complete Part 1 below to receive program information once the new UCI Ed.D. is developed. If you would like to make suggestions for the future UCI Ed.D., please let us know your preferences by completing Part 2:

Part I: Contact Information   Name: (first & last) Mr. Ms. Email:   Title:     Company/School:     Address 1:     Address 2:     City:     State:     Zip:     Country:     Phone:  000-000-0000 Type   Phone 1: home work cell   Phone 2: home work cell   Phone 3: home work cell   Phone (fax):     Best way to contact: email phone mail   Please add me to the mailing list: Yes No      Part II: Preferences for the future Ed.D. Program   1. Why would you consider pursuing an Ed.D. degree (please mark all that apply)?     a. Opportunity to improve knowledge and skills in a specific content area: b. Opportunity for professional advancement in chosen field: c. Opportunity to change careers d. Increased professional standing in order to effect educational change e. Doctoral degree is part of my personal education agenda f. Other:   2. What areas would you be interested in pursuing during your doctoral studies?     a. Educational policy and social context b. Learning, cognition, and development c. Language, literacy, and technology d. Early childhood education e. Out of school learning f. Special education g. Testing and assessment h. Professional development i. Instructional leadership j. K-12 academic administration k. Post-secondary academic administration l. Other:   3. What would encourage you to seek an Ed.D. degree (please mark all that apply)? a. Opportunity to be a full-time graduate student b. Ability to continue employment while pursuing degree (part time program) c. Ability to connect doctoral studies with professional responsibilities d. Opportunity to pursue customized program e. Opportunity to be part of a cohort of doctoral students f. Encouragement/supportive environment from current place of employment g. Time accomodation from employer h. Knowing faculty in the doctoral program i. Availability of distance learning opportunities j. Other:   4. Which types of program structure would you prefer in an Ed.D. program? a. Courses offered during the day Yes No b. Courses offered in the evenings and on weekends Yes No c. Courses offered during the summer Yes No d. Cohort-based model (student enter and progress as a group) Yes No e. Includes a Tier 2 Administrative Credential option Yes No f. Includes an option for a Master's degree Yes No g. Other: Yes No   5. How important to you are the following features in a doctoral program?     a. Cost of a program b. On campus housing c. Graduate employment opportunities d. Research opportunities e. Fellowships/scholarships, grants f. Participation in educational conferences, research institutes, research symposia: g. Other:   6. What do you consider the optimal class size for doctoral seminar classes? a. 8-12 students b. 12-16 students c. 16-20 students d. Not an important consideration   7. Which of the following would be your preferred focus in a doctoral degree program (please check all that apply)? a. Quantitative research emphasis b. Qualitative research emphasis c. Theoretical research emphasis d. Applied or action research emphasis e. Mixed methodologies   8. How interested are you in pursuing a doctoral degree in education? a. Very interested b. Somewhat interested c. Not sure d. Not very interested   9. When are you interested in entering an Ed.D. program? a. Within 1-2 years b. Within 3-5 years c. Later 10. What would keep you from pursuing a doctoral degree in education (please check all that apply)? a. Inbility to make time committment b. Inflexible program/lack of electives c. Insufficient coursework/faculty in particular area of interest d. Cost (fees/tuition) e. Lack of support from employer f. Other:   11. Please indicate your current position (please check all that apply)? a. Teacher/faculty member b. Administrator c. Technology-related position d. Student services position e. Student f. Other:   12. In which sector is your current position? a. K-12 education b. Community college c. Other post-secondary education d. Business/industry e. Government/politics f. Community-based organization g. Military f. Other:   13. What would be the features of an ideal Ed.D. program?