NEO GOLD Program Application
NEO GOLD Program Application
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Information
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Online Class
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Paid Job
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Job Information
Contact Information
Name
Name
First
Last
NEO ID Number
Address
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Canada
Australia
Netherlands
France
Germany
-------
Afghanistan
Albania
Algeria
Andorra
Antigua and Barbuda
Argentina
Armenia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
Gabon
Gambia
Georgia
Ghana
Gibraltar
Greece
Grenada
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Email
Phone
Date of birth:
Date of birth:
/
MM
/
DD
YYYY
Gender
Male
Female
Non-binary
Prefer not to say
What are your reasons for taking an online class? Check all that apply.
What are your reasons for taking an online class? Check all that apply.
I need this class, but it's not offered at a time that I can take it on campus.
I work and go to school. Taking online classes helps me to do both.
I'm a student athlete, so this helps me keep up with my studies.
I have a long commute, so taking online classes helps me to come to campus less.
I like online classes because I get more attention from the teacher.
I like online classes because I have more time to finish assignments.
I like the flexible schedule of an online class.
I'm not sure I will like an online class, but I wanted to try it.
Other (please specify)
Other (please specify)
How many classes are you taking?
What do you plan to study at NEO?
What do you like to do in your free time (please include campus activities you plan to participate in, if any)?
What is it about being part of the GOLD program that is most interesting to you? Check all that apply.
What is it about being part of the GOLD program that is most interesting to you? Check all that apply.
The mentor is another student who knows how to do well in online classes.
I can work with my mentor online.
I want to learn better online skills so I can have an easier time balancing school and work.
I need all the help I can get in school, and I will learn new ways to be a better student in regular classes and online.
Other (please specify)
Other (please specify)
How do you prefer to talk with your mentor?
How do you prefer to talk with your mentor?
Phone call
Text Message
Facebook
Other (please specify)
Other (please specify)
Have you taken online classes before?
Have you taken online classes before?
Yes
No
Check all that apply.
Check all that apply.
I am enrolled in at least one online course.
I am enrolled in at least one hybrid course.
I am enrolled in FYE.