BMC DURFEE HIGH SCHOOL EARLY COLLEGE INTEREST SURVEY

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Please complete this application if you are interested in learning more about Durfee's Early College Program.

Last Name *

First Name *

Current Grade *

Counselor *

Ms. Boland - Grade 10 (Last Names K-Z)

Ms. Resendes - Grade 10 (Last names A-J)

Ms. Tweedie - Grade 9 (Last Names A-LI)

Ms. Guimond - Grade 9 (Last Names - LO-Z)

Mrs. Fellows - Grade 11 (Last Names - A-L)

Ms. Pacheco - Grade 11 (Last Names - M-Z)

Mrs. Matos - Grade 11 (Health Assisting, Cosmetology, Culinary Arts, and Early Ed Pathways)

Cell Phone Number *

Early College Program is themed around Career Pathways. Please list your 1st Choice Pathway (please select 1) *

Business - Own your own Business, Marketing, Advertising, Accounting, Managing, etc

Health Science/Medical - - Physical Therapist, Nurse, Health Care, Doctor, etc

Social Service Leadership - - Non Profits, Social Worker, Government

Education - Teacher, School Counselor, Early Childhood Teacher, etc

Early College Program is themed around Career Pathways. Please list your 2nd Choice Pathway (please select 1) *

Business - Own your own Business, Marketing, Advertising, Accounting, Managing, etc

Health Science/Medical - - Physical Therapist, Nurse, Health Care, Doctor, etc

Social Service Leadership - - Non Profits, Social Worker, Government

Education - Teacher, School Counselor, Early Childhood Teacher, etc

Race/Ethnicity *

American Indian/Asian

Black/African American

Asian

Native American/Pacific Islander

White

Hispanic

Multi-Race

Required

Is English your 1st Language? *

Yes

Did your mother earn a 4 year college degree?

Yes

Unsure

Did your father earn a 4 year college degree?

Yes

Unsure

After high school, do you plan on attending college?

Yes

Maybe

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