JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Matt Cohn — Class of 2023 Student Intake
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student Last Name:
*
Your answer
Student First Name:
*
Your answer
Name of parent/guardian completing this form:
*
Your answer
Mailing address:
(For book delivery)
Your answer
High School:
*
Bay
Convent
Drew
Galileo
International
Lowell
Lick-Wilmerding
Riordan
Sacred Heart Cathedral
St. Ignatius
Stuart Hall
Urban
University
Other:
Who is your student's college counselor?
(Leave blank if not yet assigned. Please see Client Service Agreement for information about communication and confidentiality.)
Your answer
What is the first test your student will take after we begin working together?
*
Choose
Uncertain
PSAT
January SAT
February ACT
March SAT
April ACT
May SAT
June SAT
June ACT
July ACT
August SAT
September ACT
October SAT
October ACT
November SAT
December SAT
December ACT
GPA and Scores
Unweighted Cumulative GPA:
Choose
4.0
3.9
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3.0
2.9
2.8
2.7
2.6
2.5
2.4
2.3
2.2
2.1
2.0
Below 2.0
Weighted Cumulative GPA:
Choose
4.5+
4.4
4.3
4.2
4.1
4.0
3.9
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3.0
2.9
2.8
2.7
2.6
2.5
2.4
2.3
2.2
2.1
2.0
Below 2.0
Junior-year PSAT Reading Test score (leave blank if scores are not yet available):
Choose
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
Junior-year PSAT Writing and Language Test score:
Choose
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
Junior-year PSAT Math Test score:
Choose
38
37.5
37
36.5
36
35.5
35
34.5
34
33.5
33
32.5
32
31.5
31
30.5
30
29.5
29
28.5
28
27.5
27
26.5
26
25.5
25
24.5
24
23.5
23
22.5
22
21.5
21
20.5
20
19.5
19
18.5
18
17.5
17
16.5
16
15.5
14
13.5
13
12.5
12
11.5
11
10.5
10
9.5
9
8.5
8
Is your student is eligible for extended time or any other accommodations, or will you be applying for accommodations? If so, please describe.
*
Your answer
Longer Answers
Leave blank if they don't apply; we can also communicate about any of these topics later on.
Do you/your student have any target colleges and/or dream schools?
Your answer
Do you anticipate your student either being recruited to play a sport in college, or applying for programs in the dramatic/performing arts? If so, please describe.
Your answer
Is there anything else you'd like for me to know about your student?
Your answer
Please indicate high school graduation years of additional children in your family:
2024
2025
2026
2027
Agreements
I have read and agree to the Client Service Agreement.
*
Choose
Yes
My student/family will respond to surveys about final test scores and college acceptances sent in spring of 2023:
*
Choose
Yes, we will complete these short surveys!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
