Student Success Plan
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1.
Name
(Required.)
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2.
Email
(Required.)
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3.
Phone
(Required.)
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4.
High School
(Required.)
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5.
Grade Level
(Required.)
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6.
What services would benefit you? Check all that apply.
(Required.)
Exposure to different colleges
Stress/time management
PSAT/SAT/ACT prep
Financial aid information
Choosing a college major
Applying to college
Cultural activities
Career exploration
Tutoring - Which subjects?
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7.
What obstacles(s) would most likely prevent you from completing your academic goals? Check all that apply.
(Required.)
Poor study skills
Low grades
Family medical concerns
Lack of money
Separation/divorce
Taking things too seriously
Always worrying
Problems at home
Taking the wrong classes
Time management
Always feeling tired
No friends at school
Trouble sleeping
Too shy
Afraid to speak up in class
Easily distracted
Feeling depressed or sad
Recurring health issues
Lack of transportation
No family/friend support
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8.
What are your strengths? What do you do really well?
(Required.)
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9.
Where do you need specific support?
(Required.)
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10.
In 5 years, I want to be...
(Required.)
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11.
What are you interested in studying? What degree programs interest you?
(Required.)