Total Solution Questionnaire

Student Information
Name	E-mail
Phone	Birthday

Parent Information

Name

Relation
Father Mother

Primary Phone

Secondary Phone

E-mail

Street Address

City

State

Zip Code

Academic Information
School Name	Graduation Year
SAT-I CR: Math: Writing:	ACT
SAT-I CR: Math: Writing:	ACT
SAT-II Subject: Score:	SAT-II Subject: Score:
SAT-II Subject: Score:	SAT-II Subject: Score:

Course Information
9th Grade Fall Semester	Grade	9th Grade Spring Semester	Grade








10th Grade Fall Semester	Grade	10th Grade Spring Semester	Grade








11th Grade Fall Semester	Grade	11th Grade Spring Semester	Grade

Extracurricular Activites
Activity	Desciption	Hrs/Week	Weeks/Year	School Year(s)

College Information
Impossible Elite Best Fit Any
Most important factor in choosing a college
Desired Field of Study (can be undecided)

Other Information
What would you like your son/daughter to get out of meeting/program:
Completed By (optional):
Do/Did you have an appointment with our consultants?Yes No If Yes, please specify Who: When:

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Last modified Friday, 19-Sep-2008 20:39:24 EDT