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ACT
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All Resources
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301.951.0350
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New Student Survey
Name
First
Last
PrepMatters Counselor
Maureen Delaney
Katy Dunn
Maurice Jackson
Sierra Leickert
High school
High School graduation year
Date of birth
MM slash DD slash YYYY
Student Email
Parent 1 First name
Parent 1 Last name
Relationship to student
Email
Primary phone number
Type
Parent 2 First name
Parent 2 Last name
Relationship to student
Email
Primary phone number
Type
Live with
List five activities, organizations, or hobbies that are important to you.
List five activities, organizations, clubs, or hobbies that are important to you:
2
3
4
5
Choose one or more from the list above and explain what it means to you.
Do you read for fun?
What do you read?
What is your best academic subject?
Why?
Is your best subject also your favorite subject? Why or why not?
What makes a good teacher? Provide an example from your experience.
What do you consider your academic strengths or specialties, and what areas do you hope to improve?
Is there anything about your report cards that you would like a college to understand better (e.g., particular grades, high school change, challenging teacher)?
Please explain
Most students don’t know what they want to study in college or pursue afterward, but if you have some ideas for yourself, let us know here.
Do you have a dream college?
What is it, and why does it seem like a good fit for you?
Are any of the following concerns for you about the college admissions process? (Check all that apply)
Admissibliity ("getting in")
Application essays
Extra-curriculars
Finding the best fit colleges
Grades
High school course selection
Planning college visits
Standardized testing
Summer activity planning
Time management during the process
Choose three words to describe yourself
Word 3
Choose three words to describe yourself:
Word 2
Are three words nowhere near enough? If so, tell us more here:
What makes you proud?
If you could snap your fingers and change something in your life, would you?
Tell us more.
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