Name

Grade Level

Email Address

What are your favorite subjects?

Check all that apply.

• Mathematics

• Science

• English/Literature

• Arts

• Physical Education

• Technology/Computer Science

Which activities are you interested in?

Check all that apply.

• Sports

• Music & Arts

• Theater/Drama Club

• Student Government

• Volunteering Service

• Debate/Public Speaking

What careers interest you?

Would you like career counseling or mentorship?

What motivates you to learn and participate in school activities?

Is there anything else you’d like to share about your interests or goals?