Student Questionnaire

*Student Name:
*Email Address:
*Address:
*City:
*State:	Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
*Zip Code:
*Home Phone Number:	- - x
Cell Phone Number:	- - x
*Date of Birth:	Jan Feb March April May June July Aug Sep Oct Nov Dec / 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
*Current School:
*Current Grade:	Select a Grade K 1 2 3 4 5 6 7 8 9 10 11 12
*Grade Point Average:
*SAT M:
*SAT V:
*ACT:
*School Address:
*School City:
*School State:	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
*School Zip:
*Guidance Counselor (College):
*Father's Name:
Father's Address (If Different):
Father's City (If Different):
Father's State (If Different):	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Father's Zip (If Different):
Father's Home Phone (If Different):	- - x
Father's Business Phone:	- - x
*Father's Occupation:
*Father's Employer:
Father's College:
Father's Degree:
Father's Graduate School:
Father's Graduate Degree:
*What are you most proud of and why?:	(chars left: 1000)
*How have you contributed to your school?:	(chars left: 1000)
*What are your academic strengths and weaknesses?:	(chars left: 1000)
*What are your personal strengths and weaknesses?:	(chars left: 1000)
*What classes have you most enjoyed:	(chars left: 1000)
*Do you see yourself as the “superstar,” “leader,” or “unsung hero”? Explain:	(chars left: 1000)
*What “edge” do you have that will differentiate you from other applicants?:	(chars left: 1000)
*How do you spend your free time?:	(chars left: 1000)
*What events or experiences have shaped your growth and way of thinking?:	(chars left: 1000)
*Is there anything unusual about your family or personal background (travel, illness, adversity, etc.) which may help explain your academic experience so far?:	(chars left: 1000)
*Is your academic record to date an accurate indication of your ability?:	(chars left: 1000)
*What community service have you done thus far in high school? Be specific! How many hours?:	(chars left: 1000)
*College Planning (Select as many as apply):	[Hold CTRL or CMND key to select multiple] I think I want to go to college I have a general direction I definitely want to go to college I plan to go directly to college I’m just starting my search I’m thinking about deferring for a year I have some specific ideas
*At the moment these colleges are appealing to me:	(chars left: 1000)
*I see myself at a college in Select as many as apply:	[Hold CTRL or CMND key to select multiple] A homogeneous student body A diverse student body An urban setting A suburban setting A country setting A “small college town” New England Pacific Northwest Middle Atlantic West South Midwest No geographic preference
*I see myself at a college with Select as many as apply:	[Hold CTRL or CMND key to select multiple] Small (less than 1000) Moderate (1000-3000) Medium (3000-8000) Large (8000-15000) XL (15000-25000)
*I see myself at a college that is Select as many as apply:	[Hold CTRL or CMND key to select multiple] Conservative Moderate Liberal
*I would prefer Select as many as apply:	[Hold CTRL or CMND key to select multiple] A highly rigorous and selective program A moderately rigorous and selective program A program of limited rigor and selectivity
*I prefer coursework oriented towards (Select all that apply):	[Hold CTRL or CMND key to select multiple] Liberal arts Technical Engineering Pre-medical Pre-law Pre-architecture The performing arts Business
*I hope to play sports at the NCAA division level (Select one):	[Select One] I II III
*I have received letters from college coaches (Select one):	[Select One] Yes No
*I have spoken with college coaches (Select one):	[Select One] Yes No
*Colleges that have sent me letters:	(chars left: 1000)
*Colleges I am interested in:	(chars left: 1000)
Please feel free to include anything that may help us get to know you better as well as letting us know what type of college would be your ideal match:	(chars left: 1000)