Bluegrass Community & Technical-Lexington-TS-Needs Assessment

Date

mm-dd-yyyy

School

Grade

Name

First NameMILast Name

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Cell Phone

(999)999-9999

Student Cell Phone

(999)999-9999

Student Email Address (A non-school email that you check regularly)

example@example.com

Parent email

example@example.com

Do you have access to wifi at home?

Preferred name:

What is your favorite class or subject?

What is your least favorite class or subject?

What is your GPA?

If you don't know just put 'mostly A's, mostly B's, ect.)

Which class(es) do you think will cause you the most difficulty this year and why?

Please rate your answers:

Rows	1 (Strongly Disagree)	2 (Disagree)	3 (Neutral)	4 (Agree)	5 (Strongly Agree)
I need to hand in homework on time.
I need to improve my GPA.
I need to have a better attitude toward school.
I need to learn how to take better notes.
I need to develop stronger study skills & habits.
I need to learn test-taking strategies & how to reduce test anxiety.
I need help deciding which classes to take.
I need to learn how to listen more effectively in class.
I need to learn how to participate in classroom discussions and to communicate more effectively.
I do not understand what is meant by pre-college curriculum (PCC).
I need help understanding dual-credit, advanced placement, honors, etc.

At this time, I am considering the following colleges:

1.

2.

At this time, I am considering the following careers:

1.

2.

3.

Please rate your answers:

Rows	1 (Strongly Disagree)	2 (Disagree)	3 (Neutral)	4 (Agree)	5 (Strongly Agree)
I need help in deciding which type of postsecondary institution (i.e. college) to attend.
I need to visit more colleges in order to make a decision about where I want to go.
I need to learn more about college admission requirements.
I need college entrance exam testing information and preparation (ACT, SAT, etc.)
I need to learn more about financial aid and scholarships.
I need help deciding which careers best fit my skills & interests.
I need to know how to prepare for careers that interest me.
I need to know how to apply and interview for jobs.

List any extra-curricular activities you will participate in this year:

My t-shirt size is: (circle one) (Adult Unisex Sizing)

Please rate your answers:

Rows	1 (Strongly Disagree)	2 (Disagree)	3 (Neutral)	4 (Agree)	5 (Strongly Agree)
I need to become more familiar with people of other cultures, backgrounds, etc.
I need to develop confidence in myself.
I need to work on my communication skills and relationships with others.
I need to set goals and follow through with them.
I need to accept responsibility for my actions.
I need to learn how to make decisions.
I need to learn how to manage my time and achieve a balance between, academic, extra-curricular,
and personal activities.
I need a mentor to provide me guidance about college and my future.
I have a trusted adult in my life I can talk to about my future.
I am financially required to work during the school year.
I have reliable transportation.

Is there anything else you would like us to know at this time?

I agree to follow the TRIO Educational Talent Search at BCTC guidelines by attending all workshops, following school rules and teacher expectations, and by striving to do my best academically. I will ask for help with any situation in which I need it.

Student Signature

Date

mm-dd-yyyy

Annual Update Form & Needs Assessment

Academics

Colleges & Careers

Personal