STUDENT INTAKE questionnaire

Student Name

First Name

Last Name

Date

YYYY

Grade

Prospective Transfer

Prospective Grad Student

Name of current school:

List three adjectives that describe you and explain why you chose them:

What do you consider your greatest strengths and weaknesses?

Which extracurricular activities, clubs, and/or sports have been most meaningful to you? Have you held any leadership positions in them?

Have you ever won any academic honors or prizes during middle school or high school? If so, please give a list of each honor/prize/award alongside the grade(s) in which you won them:

Have you ever held a paid job? If so, what was it? Please explain the time commitment involved, as well as the duties of the job:

Have you ever completed volunteer work? If so, what kind? Please explain the time commitment involved, as well as the name of the organization for which you volunteered:

How do you typically spend your summer? Do you have any plans for next summer already?

What did you enjoy the most about your middle, high school, or college experience?

What did you enjoy the least about your middle, high school, or college experience?

What is your biggest source of concern or anxiety, as it relates to the admissions process ahead?

Are you currently interested in any specific colleges (or high schools, graduate programs, if applicable)? If so, please name them:

Do you know for a fact that you are NOT interested in any particular high schools, colleges, or graduate programs? If so, please name them:

Are you currently interested in any specific majors or fields of study? If so, please name them. If not, please share your favorite subjects in school or areas of study:

Is there anything else that you think would be helpful for me to know about you? Are there particular questions or topics that you would like me to cover during our initial session?