City Honors School Class of 2019 Exit Survey: Due by Wednesday, May 1, 2019
All questions must be answered. If a question has an answer that is not applicable to you, simply type: N/A.

Please note that much of the information you are providing in this form is used for the graduation program. The information in the program will only be as good as the information you provide.

A supplemental form will be made available for any updates after May 1st (more scholarships, a change in where you are going to college/university, etc.).

Last Name: *
Your answer
First Name: *
Your answer
Email: *
Your answer
Mobile phone number (only used for graduation related issues): *
Your answer
Permanent Address (full address including zip code): *
Your answer
Parent/Guardian Names: *
Your answer
Parent/Guardian Address (if different from above): *
Your answer
Please list all of colleges/universities at which you were accepted (please indicate in parentheses after the name if it is an Honors Program): *
Your answer
What is the name of the college/university you will attend next year?: *
Your answer
Are you enrolling in an Honors Program? (If so, please list the name of the program): *
Your answer
If you have an anticipated major, please list it: *
Your answer
If applicable, please list NCAA sport and division (I, II, III) you will play in college (type N/A if not applicable): *
Your answer
What is the full address of where your final high school transcript needs to be sent (office name, college name, street address, city, state, zip code): *
Your answer
How do you want your name written on your diploma?: *
Your answer
How do you want your name listed in the graduation program?: *
Your answer
How do you want your name read aloud at graduation? (Please include phonetic pronunciation if necessary): *
Your answer
In the spaces below, and EXCLUDING Say Yes and need-based grants/financial aid, please list ALL of the scholarships/grants you have received from all institutions (regardless of whether you intend to accept them). Please list the name in the first question and the amount and time period (ex: $30,000/four years) in the question following it. If you received no scholarships, or there are more spaces than scholarships, type N/A on the lines you do not need. If you have over 10 scholarships, please use the supplemental senior exit survey as well. *
Required
Scholarship #1 name (& college it's for, if applicable): *
Your answer
Scholarship #1 amount and time period (ex: $4000/year or $25,000/four years): *
Your answer
Scholarship #2 name (& college it's for, if applicable): *
Your answer
Scholarship #2 amount and time period (ex: $4000/year or $25,000/four years): *
Your answer
Scholarship #3 name (& college it's for, if applicable): *
Your answer
Scholarship #3 amount and time period (ex: $4000/year or $25,000/four years): *
Your answer
Scholarship #4 name (& college it's for, if applicable): *
Your answer
Scholarship #4 amount and time period (ex: $4000/year or $25,000/four years): *
Your answer
Scholarship #5 name (& college it's for, if applicable): *
Your answer
Scholarship #5 amount and time period (ex: $4000/year or $25,000/four years): *
Your answer
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