DesignWorlds for College Transfer, Graduate School & Majors/Career Exploration: Student Information

1. Personal Information

This survey is designed to help us be more effective in assessing your background, interests and needs for DesignWorlds for College Transfer, Graduate School and/or Major or Career Exploration services and programs. All information you enter will be held completely confidential and will not be shared with anyone except members of our DesignWorlds staff.

Those items marked with an asterix (*) are required; others may be optional, but answer as many of the questions as you can.

Thank you!

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* 1. Name (Last, First):

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* 2. Date of Birth:

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* 3. High School where you graduated:

Name

City, State

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* 4. College or university you're currently attending or graduated from:

Name of college/university:

City, State

(Planned) Year of Graduation

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* 1. Name (Last, First):

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* 2. Date of Birth:

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* 3. High School where you graduated:

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* 4. College or university you're currently attending or graduated from:

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* 5. What year are you enrolled in college now (or did you already graduate)?