Clone of Student Intake Form

STUDENT INTAKE FORM

Discovery Bundle
This is where your report starts. The questions below help us understand your academic background and career interests better. Be specific — vague answers produce vague results. The quality of your assessment depends directly on the quality of your answers. Don't rush it. There are no right or wrong answers — only honest ones.

If you don’t know the answer to a question, or don’t feel comfortable answering, feel free to skip it.
SECTION 1: WHO YOU ARE
Full Name

First NameLast Name
Email - This is where your bundle will be delivered.
What is your current year in college?
SECTION 2: YOUR ACADEMIC PICTURE
What are your three strongest subjects or courses — where you've performed best or felt most engaged?
What are your three weakest subjects or courses — the ones you've struggled with most or actively avoided?
SECTION 3: YOUR MAJOR
What college OR university do/will you attend?
What is your current major/minor? Please leave it blank if you don't know yet.
What are the majors, minor(s), and/or concentrations you are considering? (Please specify if you would like us to focus on the majors, minors, concentrations you list here or you would like us to explore majors beyond the list you provide here.)
Which of these best describes where your natural strengths show up? Select all that apply

Other
Which subjects or academic areas have you performed well in, even if they weren't your favorites? Select all that apply.

Other
Which subjects or academic areas have you already ruled out. Select all that apply.

Other
SECTION 4: YOUR CAREER
When you imagine work that would feel meaningful to you, what does it involve? (Check all that apply)

Other
What are the most important thing(s) to you regarding your future career? Rank them by importance.
Are there specific companies, organizations, sectors, or industries you want to work in?
SECTION 5: THE HONEST QUESTION
This section matters more than any other. Be specific. Vague answers produce generic assessments.
If money, prestige, and other people's opinions were completely off the table -- what would you study?
What problem in the world do you most want to work on, even if you don't know how yet?
Is there anything else you want us know before we begin your assessment — anything that doesn't fit neatly into the questions above?
SECTION 6: PARENT ADD-ON
What outcome are you hoping this assessment produces for your child?
Are there fields or careers you're hoping to see on or off the list? Be honest, this will help us flag potential conflicts.
Anything else we should know before we begin?
Please attach your transcript:

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Please attach your resume:

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*Your signature below indicates that the information you have provided above is truthful.
Date

MonthDayYear
Date
Signature
Reports will be delivered within 72 calendar hours. Orders received after 5:00 PM ET on Friday or during weekends will begin processing the following Monday at 9:00 AM ET. The 72-hour delivery window for such orders begins at Monday 9:00 AM ET, regardless of when the order was originally submitted.

My Products

DISCOVERY BUNDLE

$169.00 Quantity

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

STUDENT INTAKE FORM

SECTION 1: WHO YOU ARE

SECTION 2: YOUR ACADEMIC PICTURE

SECTION 3: YOUR MAJOR

SECTION 4: YOUR CAREER

SECTION 5: THE HONEST QUESTION

SECTION 6: PARENT ADD-ON

My Products*

My Products