Post-Secondary Counseling Initial Intake Form
By completing this survey, you are providing our office with valuable information that will serve as a foundation for our conversations about your plans for life beyond high school.
General Information
Student Name
*
First Name
Last Name
Preferred Email
*
example@example.com
Did your parents attend college? If so, where?
*
Do you have an older sibling(s) in college or who has gone to college? If so, where?
*
How would you define success after high school?
*
For example, is it being admitted to a particular school? Making a lot of money? Having a work-life balance? Studying or doing something you love?
What are your favorite subjects?
*
Are you an athlete, artist or musician interested recruiting, auditions and/or portfolios?
*
Please specify
What do you enjoy doing in your free time?
How do you manage stress?
*
College or Post-Secondary Information
Are you interested in exploring:
*
Career-Focused Training
Professional Certificate
2-year education
4-year College Degree
I'm not sure
Have you visited any colleges campuses? If so, please list them below
*
Do you plan to pursue financial aid/scholarships?
*
Yes
No
I'm not sure
In terms of size, do you think you prefer?
*
Small: under 3,000 students
Medium: 3,000-8,000
Large: 8,000-20,000
Very Large: over 20,000
I'm not sure
Submit
Should be Empty: