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* 1. Please enter your first and last name

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* 2. Please enter your Carroll Community College email address.

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* 3. Please enter your cellphone number (you may be contacted for follow up from the program coordinator).

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* 4. What high school did you graduate from?

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* 5. Is this your first time enrolling in college?

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* 6. What is your intended major?

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* 7. List any extracurricular activities you were involved in at your local high school and/or in your community. Please include involvement in clubs/organizations, sports, community service, work experience, church, or other opportunities.

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* 8. True or False: Neither of my parents and/or guardians have completed an associate and/or bachelors degree.

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* 9. Students in this program are expected to attend and participate in monthly programming which is designed to assist you with the successful transition to college. Students will also attend one on one check ins with their assigned mentor in person, via phone, or via teams. Please choose below that you agree or do not agree with these requirements.

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* 10. What is your goal in attending Carroll Community College?

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* 11. What concerns do you have about the transition to college?

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* 12. If you plan to work and take classes, how many hours do you anticipate working each week?

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* 13. Students participating in our program will receive a scholarship. Full time students (12 billable hours or more per semester) will receive a scholarship of $600. Part time students (less than 12 billable hours per semester) will receive a scholarship of $300 (funds release half in the fall semester, half in Spring). This scholarship is renewable for 2nd year based on satisfactory attainment of academic standing

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* 14. How did you hear about the First in My Family program?

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* 15. What is your t-shirt size?

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