Updated Contact Form- Class of 2024

Updated Contact Form

Please take a moment to fill out this survey
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Email (non-school account: gmail, apple, etc.)*
example@example.com
Phone Number*
Please enter a valid phone number.
Please enter your date of birth (month/date/year)
Please enter your student ID number
Grade Level*

9101112
School*

Banneker High SchoolCreekside High School
Do you have social media accounts? Please provide your account name.
Instagram blank
TikTok  Type a label
Facebook   Type a label
Twitter   Type a label
SnapChat   Type a label
Parent's Name*

First NameLast Name
Parent's Phone Number*
Please enter a valid phone number.
Extra-curricular activities (Sports/Clubs/Organizations)*

NONEBasketballFootballUpward BoundBeta ClubChorusAVIDCheerleadingRoboticsGEAR UpDual EnrollmentOther (please use the space provided below to list any other activities)
Extra-curricular activities (other)
College Applications (please list all college you have applied to)*
College Acceptance (please list all college you have applied to)*
Career Choices (please list top 3)*
SAT/ ACT Please list the dates you have taken the tests and the scores you received (example- "December 2023- 1020")*
After high school, plan to:*

College/ Job TrainingWorkMilitary
I think that College is:*

Necessary for my futureWaste of time/moneyJust not for me
Planning for my future is:*

Very importantNot currently my main concern

College Plans*

Career Plans*

	YES	NO
I have a plan for my future
I know what I need to do to achieve my plan
I need help to figure out what to do with my life after high school
Exploring my career options is of interest to me
I need to know how to prepare for careers I want to pursue
I would like to talk to or visit people in the workforce to learn about careers
I need help to understand my strengths, abilities, interests and traits
Attending college or other programs after high school DO NOT relate to my career choices

General QUestions*

	YES	NO
I would like to go on field trips to college campuses & other educational experiences
I know how to manage my time
Being organized is one of my strengths
I need to accept more responsibility for my actions
Self-confidence is something I feel I have
Setting goals for myself is important
I need to learn how to solve problems and make better decisions
Talking with my parents/guardians about my future is difficult
I have a computer at home
I have access to the internet at home