First in Class Registration Form

Join the 6-week support group for first generation college students and graduates facilitated by Derek Cooper, LMHC, NCC.

Participation Fee: $500

Limited slots! Reserve now!

Virtual Support Group Schedule
September 28	4:00 PM - 5:30 PM PT
October 5	4:00 PM - 5:30 PM PT
October 12	4:00 PM - 5:30 PM PT
October 19	4:00 PM - 5:30 PM PT
October 26	4:00 PM - 5:30 PM PT
November 2	4:00 PM - 5:30 PM PT

Name

First NameLast Name

Phone Number

Email

example@example.com

Birthday

Date

How did you hear about this support group?

Were you the first in your family to enter college?

YesNo

If not, which relatives were?

Did you graduate from college?

YesNo

Have you ever had a support network of other first generation college students?

YesNo

What was your perspective on pursuing a higher education? Who inspired you to seek it out?

Did you perceive being a first generation college student as a negative or positive? Why?

How did your family discuss college, careers, and adulthood?

Any additional comments or information you would like to share?

About you