First Name Last Name
Adress Please Check Address:
Email Address Student ID  
Phone Numbers Residence Cell
Nationality Expected Graduation Date
Please describe how your academic life is going. (Be specific: e.g., grades, study habits, class attendance, interactions with faculty, etc.)
Who has influenced your career interests and why?
Current GPA: Current Major(s):
I would like assistance in the following area(s):
What do you do for fun?
What skills or gifts do you believe that you possess?
If you could design your ideal job, what would it include?
Select the item(s) that is/are the most important for your career:
What steps, if any, have you taken before making this appointment?
Is there any additional information about yourself that you would like to share with us that could assist us in this process?