Transfer Student Questionnaire

Please fill out and either e-mail, fax or mail to our office: counseling@excellencematters.com
PO Box 7912, Round Rock, Texas 78683 or Ph. (512) 689-9559, Fax. (512) 670-3294

Student's Name:

Nickname:

Father's Name:

Mother's Name:

Student's Home Address:

Home telephone:

e-mail:

Home Fax:

Social Security # (optional):

Date of Birth:

Name of School attending:

Current G.P.A.

Student's school phone number:

School e-mail:

Are your parents or any other relatives significantly involved in any college of possible interest to you? If
so, please name the colleges:

(1) What type of college do you see yourself in? Please review the characteristics listed below and on the next page, and review your current priorities before checking the appropriate line. You may wish to discuss your answers with your parents prior to completing the questionnaire:

College Geographic Location? Please number choices from 1 (most desirable) to 5 (least desirable):
Northeast ____ Mid-Atlantic ____ Mid-West _____ South _____ Far-West _____ Doesn't matter ____

College Setting?
Urban ______ Suburban ______ Rural _____ Doesn't matter_____

College Size?
Very Small (under 1,000 undergraduates) _____
Small (1,000 - 3,500) ______
Medium (3,500 - 6,000) ______
Large (6,000 - 15,000) ______
Very Large (15,000 - 35,000) ______

Type of Institution?
College (undergraduates only) ______
University (undergraduates, graduate and
professional students) ______
Doesn't Matter _____
Coeducational ______
Single Sex ______
Doesn't Matter ______

________________________________________

Atmosphere?

Conservative _____ Traditional ______ Middle-of-the-Road ______ Liberal _______ Alternative _____

What characteristics would you like to incorporate?

What characteristics would you like to avoid?

How important a consideration is institutional prestige?

(2) Intended Major:

Possible Majors if undecided:

How intensive an academic workload do you want:

Academic interests apart from your major:

(3) List the courses you are currently taking and your approximate grades:

(4) Tests taken to date and scores:
PSAT V ______ M ______ W ______
SAT I V ______ M ______ Date ______
SAT I V ______ M ______ Date ______
SAT II Subjects: Writing _______ MIC ______ MIIC ______ Biology ______
Chemistry ______ Physics ______ Am.History ______ Other ______ Other ______

(5) Please list your most important extra-curricular pursuits. Specify years of involvement and positions of leadership or responsibility, and indicate which ones are most important to you:

School Activities:

School Sports:

Outside Activities:

Work and Summer Activities:

Hobbies and Interests:

Awards, Honors, Recognition (academic and others):

(6) Are there any colleges in which you are particularly interested at this time? Please name them and explain why:

Have you ruled out any colleges? Please name them and explain why:

(7) Will you need financial aid?

Do you want a part-time job?

(8) How would you assess yourself as a student? What do you consider your academic strengths and weaknesses? Do you think your transcript and teacher/counselor reports accurately reflect your academic abilities?

(9) Tell us anything about yourself that would help us understand you better - your personality, values, background, interests, aspirations - other significant people in your life, etc. Please give as thoughtful a response as possible:

PLEASE NOTE: We would like to have your completed student questionnaire at least one day prior to your appointment. Copies may be e-mailed, faxed or mailed to us. Please include any testing results, current grades and school transcripts (if available), as well as any other material which will help to illuminate your academic and social progress thus far.

Click here to download form

You can fax the form to (512) 670-3294 or mail form to PO Box 7912, Round Rock, Texas, 78683.