Educational Talent Search
High School Reactivation Form
Student Information
Name
*
First Name
Middle Name
Last Name
Today's Date
-
Month
-
Day
Year
mm-dd-yyyy
Date of Birth
*
-
Month
-
Day
Year
mm-dd-yyyy
School
*
Clarke Central
Warren County High
Cedar Shoals
Elbert County High
Hancock County High
Wilkes County High
Grade
*
Your School Email Address
*
example@example.com
Parent's Email Address
example@example.com
Guradian(s)/Paren(s) Full Name
First Name
Last Name
Home Mailing Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Your Cell #
*
Parent Cell #
Emergency Contact Person
Relationship to you
Emergency Telephone
Are you on social media?
Facebook
Instagram
Twitter
Other
If so, how can we find you?
Needs Assessment
1) Are you currently participating in any of the following? (Please check one)
*
Educational Talent Search (ETS)
Upward Bound
N/A
2) Do you have any special needs?
*
Yes
No
List:
*
3) Have you ever considered dropping out of school?
*
Yes
No
4) Do you meet with your school counselor at least once per semester?
*
Yes
No
5) Do you need to develop/improve your study skills?
*
Yes
No
6) In which subject(s) do you need tutoring? List:
*
7) How many years of postsecondary education do you plan to complete?
*
1 - 2 years: Associate Degree/Technical School
3-5 years: Bachelor's Degree
6+ Master's or Doctorate Degree
Uncertain at this time
Will not attend
8) Do you know the high school classes that should be taken to prepare for college?
*
Yes
No
9) Are you currently enrolled in college preparatory classes?
*
Yes
No
Needs Improvement
9) Do you know how to handle conflicts without fighting?
*
Negative
Positive
Positive but Needs improvement
10) Do you know the procedure(s) for admission to a postsecondary institution?
*
Yes
No
11) Have you contacted any college(s) for admission information?
*
Yes
No
12) Have you begun academic preparation for the PSAT, ACT or SAT?
*
Yes
No
13) Will you need a college application, ACT or SAT fee waiver?
*
Yes
No
14) Are you aware of financial aid programs that will assist you with paying college tuition?
*
Yes
No
15) Will you need assistance applying for financial aid or scholarships?
*
Yes
No
16) What is your current career interest?
*
(Band, chorus, FBLA,etc.)
17) Do you know facts about this career?
*
Yes
No
18) Do you know the college major that will prepare you for this career?
*
Yes
No
19) Do you participate in extracurricular activities?
*
Yes
No
20) Are you currently in foster care or ever been homeless?
*
Yes
No
22) During this academic year, how can Educational Talent Search assist you in becoming a better student?
*
23) What colleges would you like to visit/tour this school year?
*
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