Needs & Service Assessment

Needs & Service Assessment
Name*

First NameLast Name
Date*

MonthDayYear
Date
What obstacle(s) would most likely prevent you from completing your academic goals? (Check all that apply):

Poor Time managementUndecided about major/careerLack of family/friend/community supportAfraid I might not fit in at collegeDifficulty reading and understanding textbooksAfraid of failing gradesDifficulty managing moneyTransportationHousing InsecurityFood InsecurityAnxiety/DepressionPoor note taking skillsI cannot afford my textbooks/tuitionI do not know how I best learnOther
Check all of the following services that may interest and/or benefit you while attending Prairie State College
Advising

Academic Advising/Registration AssistanceFinancial Aid Application AssistanceCareer Exploration/AdvisingIndividual Support/Monitoring
Transfer Planning:

College Transfer InformationCollege Application Assistance & AdviceCollege VisitsFunding
Tutoring

English/WritingReadingScienceMathOther
Workshops

Time ManagementEconomic & Financial LiteracyTest Taking StrategiesStudy SKills
What are your short term goals (This semester)?:
What are your long term goals (This academic year)?:
What academic challenges are you facing?
What other demands do you have on your time?
How can TRIO SSS support you to achieve your goals?
Should be Empty:

Check all of the following services that may interest and/or benefit you while attending Prairie State College