PASS Intake Form

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PASS Intake Form

PASS means Pioneers Achieving Student Success! The PASS Program is an initiative of TWU Academic Advising and provides students with the academic support and resources they need to develop a plan towards achieving success.

Please complete the intake form before your PASS appointment. The information helps your PASS Advisor in meeting your needs.

First and last name *

ID number (7 digits that starts with 1 or 0) *

Telephone Number *

TWU Email Address *

Pronouns *

She/Her

Them/They

He/Him

Per/Pers

Ze/Zie/Hir

Xe/Xem

Other:

Race/Ethnicity *

African-American/Black

Latino/Hispanic

Bi-racial/Multiracial

White/Caucasion

Asian/Asian-American

Pacific Islander

Native-American

Other:

Marital Status *

Single

Married

Divorced

Separated

Other:

Are you a parenting student? *

Yes

Have you ever or are you currently serving in the United States Armed Forces? *

Yes

Are you a first generation college student? (Neither of your parents have a bachelor's degree) *

Yes

While enrolled in classes, where do you reside? *

Residence Hall

Greek Chapter House

On-campus apartment

Off-campus

Other:

Select your employment status *

Not currently employed

Full-time off campus

Full-time on campus (staff member)

Part-time on campus

If you are working, approximately how many hours per week do you work? *

5-10

11-20

21-30

30-40

40+

Other:

Are you a transfer student? *

Yes

Have you been on academic probation before this semester? *

Yes

I am not sure.

Have you ever been placed on academic suspension? *

Yes

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