Senior Transition Survey

The purpose of this survey is to collect your contact information and to plan activities which align with your future career interests. Thank you in advance for your cooperation. To complete online go to www.jenningsk12.org/Warriorconnections and click and select Senior Transition Survey.

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* 1. Please provide the following information. Place N/A where you do not have a response.

First Name: *

Last Name *

Email Address:

Cell Phone Number:

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* 2. Please provide your user name for your social network site(s). Place N/A where you do not have a response.

Facebook

Twitter

Linked-in

My Space

Other

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* 3. Please provide your primary parent/guardian contact information. Place N/A where you do not have a response.

Parent Name

Parent Email:

Parent Phone Number:

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* 4. Please provide your second parent/guardian contact information. Place N/A where you do not have a response.

Second Parent Name

Second Parent Email:

Second Parent Phone Number:

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* 5. Please provide the name of the person who will always be able to contact you (grandparent, aunt, uncles, etc.)

Name:

Relationship:

Telephone Number:

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* 6. Please select a program of interests.

Flo-Valley Dual Enrollment (On Campus)

UMSL Dual Enrollment (On Campus)

Harris Stowe Dual Enrollment (On Campus)

Pharmacy Tech Program (JSH)

Certified Nursing Assistant (CNA) (On Campus)

Ranken Tech Dual Enrollment (On Campus) (if selected please answer question 7)

Other (please specify)

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* 7. Please Check which program at Ranken that interest you.

AS or BS in Architectural Technology – 6 cr hr

Automotive Collision Repair Technology – 14 cr hr

Automotive Maintenance Technology – 12 cr hr

High Performance Racing Technology – 12 cr hr

Carpentry & Building Construction Technology – 13 cr hr

Industrial Technology – 13 cr hr

Heating, Ventilation, Air Conditioning and Refrigeration Technology 13 cr hr

Precision Machining Technology – 16 cr hr

Information Technology - 15 cr hr

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* 8. Please select your plans for the fall of 2013 after high school graduation (Select all that apply)

Attend 4-Year College

Attend 2-Year College

Attend Non-College Credit School (Trade or Technical School)

Enlist in the Military

Other (please specify)

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* 9. What are your career interest? (ex. teacher, lawyer, chef, nurse etc.). Place N/A where you do not have a response.

Career Choice 1.

Career Choice 2.

Career Choice 3.

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* 10. List 5 Colleges of Interest and Military Branch(es) of Interest (if you do not have a response place N/A)

College/Vocational School

Military Branch