Student Survey – Transition to College - Moxie College Counseling

Student Details

Your Name *

First

Last

College/University Name *

High School *

Intended College Graduation Year *

Date of Birth *

Parent Details

Parent/Guardian 1

First

Last

Relationship to Student

Add Parent/Guardian 2?

Yes
No

Contact Information

Your phone number *

Phone type *

Secondary phone number

Phone type

Email *

What excites you about going to college? What anxieties do you have?

If you already know your academic/professional direction, please describe it here. If you're unsure, please describe your academic/professional exploration so far.

What academic resources have you found helpful (e.g., tutoring, study hall, learning accommodations)? Are there any resources you wish you had?

Are you currently in any programs or communities, including extra-curricular activities, that have enhanced your high school or personal experience? If so, describe them.

Do you currently have any mentors that have made a significant impact on you?

What are some of your current responsibilities (e.g., personal, family, job)?

Is there anything else you'd like us to know before your first session?