Academic Self-Assessment

Please Read Before Completing Academic Self-Assessment

The following form will ask you to provide information that will allow us to best support you and your success as a Southern student! Any information you provide (personal, medical, etc) is optional. You are not required to provide any information you wish to keep private.
Sexual Misconduct

Please be aware that if you report or disclose an incident of sexual misconduct to a university employee, they are required to inform the University’s Title IX coordinator so that you may receive all supports, resources, and reporting options, available to you.
By clicking "I understand", you indicate that you have read the information above and understand that any information you provide in this assessment is optional.*

I understand

Academic Self-Assessment

Please thoughtfully complete this assessment and be prepared to discuss the topics with a Success Coach. It will help them identify which support services are best suited for your needs! It will take about 15 minutes to complete
Name*

First NameLast Name
Southern email address*

Confirmation Emailexample@southernct.edu
Student ID number*
Current Major*
Do you have a second major?*

NoYes
Second Major*
How do you feel about your major?*

I love my major and am 100% confident in my decision!I'm fine with my major but I don't love itI feel indifferent about my major. I don't love it but don't hate it.I'm not happy with my choice of major.I hate my major!I don't know enough about my major to have feelings about it.Other
What are your favorite subjects in school and why?*
Do you have any thoughts on what you might want to study for a major?*
Obstacles

Please take a moment to identify the issues that you feel may have impacted your grades and performance over last semester. Select all that apply and add "other" if there is something that is not on this list. YOU ARE NOT REQUIRED to provide any information you wish to keep private.
PERSONAL/OTHER

FinancialWorking too muchTransportation issuesNot having a safe/consistent place to sleepNot having a reliable source of food/healthy mealsOver-involved with extra-curricular activitiesStress, anxiety or tensionPhysical health issuesMental health issuesAlcohol and/or other substance useDisabilityLack of motivationTechnology issuesOther
FAMILY/SOCIAL

Residence hall issues (roommate, noise, distractions, etc.)Relationship challengesPersonal/family situationHomesickDifficulty adjusting to college lifeHard to make friends/lonelinessTaking care of a dependent (child, sibling, etc) or parent/grandparentLoss of a loved oneOther
ACADEMIC

Study skillsTime managementWhat worked in high school doesn't work anymoreDifficult classes/not prepared for course levelUnable to understand course contentDifficulty/conflict with course instructorDifficulty with online/hybrid course formatsDifficulty concentratingAttempted too many coursesDid not attend/skipped classOther
MAJOR/CAREER

My major is too hard.I was interested in my major, but have lost interest lately.The major I chose is not what I expected.I feel like I don't know enough about my major.I don't like my major, but was pressured to do it.There's another major I'd rather pursue but I'm nervous about career options.Uncertain about my career path.
Of the obstacles you identified above, can you identify any ways to make changes in your life?*
Resources You've Used

Let us know which Southern resources/support services you've used in the past.
Please check all of the resources you've used/visited.*

Academic Advising Center/Advising SpecialistAssigned Academic AdvisorCenter for Academic Success and Accessibility Services (CASAS)Career and Professional DevelopmentCounselling ServicesDean of StudentsFinancial Literacy and AdvisingProfessor Office HoursUniversity Access Programs (SEOP, PASS, Gear Up, New Haven Promise)Other
Strengths and Interests
What are some things you're proud of from this past semester? These can be personal and/or academic*
What are your top three strengths? These can be personal and/or academic.*
SMART Goal #1 and how you plan to achieve it*
SMART Goals

Goal setting is important when developing an improvement plan! Below, identify two SMART goals for the upcoming semester.

Be sure each of your goals fit the SMART criteria below:
SMART Goal #2 and how you plan to achieve it*
What support do you feel you need in order to be successful here at Southern?*
Please share anything else you'd like us to know
Please verify that you are human*
Should be Empty:

Please Read Before Completing Academic Self-Assessment

Sexual Misconduct

Obstacles

Resources You've Used

Strengths and Interests