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Senior Interest Survey Class Of 2021
Please fill out the entire survey as accurately as possible
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
E-mail Address
*
Your answer
Gender
*
Female
Male
Other:
Ethnicity
*
Choose
White
Asian
African American or Black
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
American Indian or Alaska Native
Other
Date of Birth
*
MM
/
DD
/
YYYY
Address, City, Zip Code
*
Your answer
Cell Phone Number
*
If you have one.
Your answer
Parent or Guardian Names
*
If you have more than one please list all of them. If you do not have a parent or guardian put N/A.
Your answer
Parent or Guardian Phone Number
*
Provide the best phone number to reach your parent or guardian at. If you do not have a parent or guardian put N/A.
Your answer
Current GPA
*
Your answer
Have You Taken A SAT or ACT? If So What Were Your Scores
*
Your answer
Hobbies & Interests
*
Please list some of your hobbies & interests
Your answer
What Do You Plan To Do After Graduation
*
Check all you are considering at this time
Attend a community college (two year)
Attend a college or university (four year)
Get a full time job
Join the Military
Attend a career/technical school
Participate in an apprenticeship-training program
Other:
Required
If You Are Thinking About The Military Which Branch Are You Considering
*
If you are not considering the military click on none
None
Air Force
Army
Coast Guard
Marines
National Guard
Navy
Required
List All The Colleges, Universities, or Tech Schools You Are Considering
*
Your answer
List All The College Campuses You Have Visited
*
If you haven't visited any put N/A
Your answer
Program, Major, or Skilled Trade of Interest
*
What topic or career would you like to go to college for
Your answer
Colleges or Universities You Have Applied To
*
If you haven't applied to any yet put N/A
Your answer
Colleges or Universities You Have Been Accepted By
*
If you haven't been accepted yet put N/A
Your answer
Have You Made You & A Parent Made A FSA ID
*
FSA ID's are needed to fill out your FAFSA
Yes
No
Have You Completed Your FAFSA
*
Yes
No
List Any Scholarships You Have Applied For
*
If you haven't applied to any scholarships yet please put N/A
Your answer
Have You Been On Medicaid At Anytime In Your Life
*
Yes
No
I don't know
Do You Want To Meet With Mr. Fairbrother
*
Yes
No
Other:
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