Student Data Sheet

STUDENT DATA SHEET

Students/Parent/Guardian: The information requested on this autobiographical survey is critical in the post-secondary planning process. Completing this form will help students organize and summarize information about themselves that will be useful in assessing their options, preparing for interviews, writing essays, and completing future college or scholarship applications. It will also be valuable to your counselor when writing college or general recommendations that you may need. Please staple additional sheets of paper as necessary.

PLEASE COMPLETE AS THOROUGHLY AS POSSIBLE AND RETURN TO THE GUIDANCE OFFICE AS SOON AS POSSIBLE.

____________________________________________________ Name (first, middle, last)

_________ Date

______________________ Social Security Number (optional) Parent/Guardian Information: Name: _____________________________ Name: ______________________________ Highest level of education completed: ______________

Highest level of education completed: ________________

Name: _____________________________ Highest level of education completed: _______________ Siblings (names, ages, school/college): __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________

EDUCATIONAL DATA: Academic area(s) of greatest interest: _________________________________________ Academic area(s) of greatest difficulty: ________________________________________ Probable college major and career goal: _______________________________________ PSAT: VERBAL ________ MATH _________ SAT I: VERBAL _________ MATH _________ Dates to be taken: ________________ SAT II: Subjects to be taken: ________________ Dates to be taken: ________________ AP:

Subjects: _____________________ Score: ________________ _____________________

________________

_____________________

________________

Is your performance an accurate reflection of your ability? Yes ___ No ___ Is there anything in your high school or personal experience that you feel needs clarification (low grades, numerous absences, illness, family loss, etc.)?

EXTRACURRICULAR AND OUT-OF-SCHOOL ACTIVITIES: List the activities in which you have actively participated since grade 9 in order of importance to you. Include your plans for grade 12, hobbies, community/volunteer service. Activity

9

10

11

12

Office or leadership position held?

Hours/week

Identify any individual or team/group/club activity-related awards, honors, recognition received, or records held.

Please indicate which activities were most significant or meaningful to you.

WORK AND SUMMER EXPERIENCES: Please list all jobs you have held from ninth grade to the present, beginning with the most recent. Place of employment

Kind of work

Average hours/week

From

Dates employed To

Please list any summer study, travel, volunteer work or other summer experience you have had or plan to have during high school. Grade 9 Grade 10 Grade 11 Grade 12 PERSONAL DATA: List at least three adjectives that you, your family or friends would use to describe you. Give an example of each. _______________________ _______________________ _______________________

__________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________

Are you currently on an individual education plan or 504 accomodation plan? Yes___ No___ If yes, would you want documentation to be distributed to colleges and universities? Yes___ No___ COLLEGE CHOICES: Please check your preferences for each question: 1. College size: _____small (> 1,000 – 3,000) _____medium (3,000 – 10,000) _____large (10,000 – 18,000) _____huge (over 18,000) 2. Geographic region: ____Northeast ____Southeast ____South ____Midwest ____West Coast 3. College majors being considered: __________________________________________ 4. Cost:

___low ($2,000-$8,000) ___upper medium ($12,000-$20,000)

___medium ($8,000-$12,000) ___high ($20,000 & higher)

Will you apply for financial aid? Yes___ No___ List the names of colleges you are considering at this time: _______________________________

___________________________________

_______________________________

___________________________________

_______________________________

___________________________________

_______________________________

___________________________________

_______________________________

___________________________________