Online Student Questionnaire

Dear Student

Thank you for choosing College Solutions as you begin the journey to determine the very best fit for your college education. To help us, and you, best achieve your goals, please complete this questionnaire and return it to us prior to our first meeting.

Part I - Demographic Information About You and Your Family

Your Name
Preferred Name
Primary Home Address
Home Telephone
Mobile Phone
Home Fax
Date of Birth
Current Grade
Social Security Number (Optional)
Preferred Email Address
Father's Name
Mother's Name
With whom do you live?
Mother and Father
Mother only
Father only
Current School
School Address
School Phone
School Email Address

Please list all schools you have attended since beginning the Ninth Grade, and dates of attendance.
School(s) Dates

Names, Ages and Colleges where any siblings attend/ed
Name Age College

Father’s Educational History, Degree(s)
College Degree Grad Year

Mother’s Educational History, Degree(s)
College Degree Grad Year

Are your parents and/or relatives associated in any way with any college or university that may be of interest to you? If so, please list these institutions


Part II - Demographic Information About You and Your Family

The following questions will help us, (and you) determine if you have done some preliminary thinking about the types of colleges/universities you may be interested in, or may have ruled out of consideration. We suggest you confer with your parents before completing this section of the student questionnaire.

For each of the characteristics listed below, please number your choices from
1 (most desirable) to 5 (least desirable)
Note: you may assign the same value to more than one choice.

1. GEOGRAPHIC LOCATION
Northeast Mid-Atlantic
Midwest South
Far-West Doesn't Matter

2. COLLEGE SETTING
Urban Suburban
Rural Doesn't Matter

3. COLLEGE SIZE
Very Small (under 1000 students)
Small (1000 – 5000)
Medium (5000 – 15,000)
Large (15,000 – 25,000)
Very Large (25,000 plus)

4. COLLEGE TYPE
College (Undergraduate students only)
University (Undergraduate, Graduate Student and Professional Students)
Doesn’t Matter

5. GENDER
Single Sex
Coed
Doesn’t Matter

6. ENVIRONMENT
Conservative
Traditional
Mainstream
Liberal
Alternative
Religious

7. Are there characteristics that are essential to you? If so, please list them?

8. Are there characteristics that you wish to avoid? If so, please list them?

9. Finally, is it important to you that you attend a "name" institution?
Yes
No

10. If yes, how important?
Essential
Very
If Possible
Looking for the best fit regardless
Not Important At All

Part III - Academic Profile

1. Please list your current courses and approximate grades
  Courses Grade
English
Math
Science
Social Science
Foreign Language
Arts
Other
Other

2. Please list the scores of any standardized tests taken to date.
PSATV M W  
SAT IV M W (date)
SAT IV M W (date)

SAT II Subjects
Writing Physics
MIC Am. Hist
MIIC Other
Biology Other
Chemistry   

PLANE M R SR Comp (date)
ACTE M R SR Comp (date)
ACTE M R SR Comp (date)

Part IV - Personal and Extracurricular

Please list the extracurricular interests you have pursued that are most important to you. Be sure to indicate number of years you have participated, leadership positions you have held, and those activities that are most important to you:

1. School Activities:

2. Athletics:

3. Activities Outside of School:

4. Work and Summer Experiences:

5. Hobbies and Interests:

6. Please list all awards, honors, recognition you have received, academic, athletic and other

7. What interests do you hope to pursue in college apart from your program of study?

8. At the moment are there colleges that you are interested in attending? If so, please list them and explain why.

9. At the moment are their colleges you are definitely not interested in? If so, please list them and explain why?

10. When we review your transcripts and test scores, are these an accurate reflection of you as a student?

11. Please take this opportunity to tell us anything else you would like us to know.