Student Intake Form
If you wanted an individual appointment with the career coach, when would be the best time?
What colleges are you interested in attending? Check all that apply:
University of Arkansas at Hope - Texarkana
Southern Arkansas University
Henderson State University
Arkansas State University
Arkansas Tech University
Cossatot Community College (Ashdown)
Northeast Texas Community College (Mt. Pleasant)
Texas State Technical College (Marshall)
University of Arkansas at Little Rock
Texas A&M - Texarkana
University of Central Arkansas
University of Arkansas (Fayetteville)
What career fields are you interested in? Check all that apply
Agriculture (including Agriculture Education)
Education and Training
Government and Public Administration
Hospitality and Tourism
Information Technology (Computer Technology)
Law, Public Safety, Security, and Corrections
Marketing, Sales, and Service
Science, Technology, Engineering, and Mathematics
Transportation, Distribution, and Logistics
I am not sure
I need help:
Determining what types of careers interest me
Creating a plan to reach a certain career goal
Exploring my education options after high school (college, technical school, military, workforce, etc)
Deciding what I should major in when I go to college
Getting a job right out of high school
Joining the military
What obstacles/challenges do you face in the career planning process?
Too many interests
Not enough interests
Lack of career information
Lack of postsecondary (college/technical school) information
Pressure from others
What is the most important goal you'd like to accomplish through working with the career coach?
Who or what have been the biggest influences on your career interests? Why?
What are some careers you have considered so far?
What are your favorite school subjects? Why?
What are your least favorite school subjects? Why?
List three things you are excel at:
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