Official Graduate Survey 2019
All seniors must complete this form online in order to receive graduation tickets and your diploma. In addition, students must turn in a copy of scholarship award letters in order to be recognized for their accomplishments.
Last Name *
as it appears on your birth certificate
Your answer
First Name *
as it appears on your birth certificate
Your answer
Middle Name
as it appears on your birth certificate
Your answer
Rocket Power Teacher Name *
Your answer
Permanent Address *
Street Name, City, State and Zip Code
Your answer
Home Phone Number:
Include area code
Your answer
Student Cell Phone #
include area code
Your answer
Parent Cell Phone #
include area code
Your answer
Student Email Address:
Your answer
Race: *
you may choose multiple options
Gender: *
What are your plans after high school? Choose one: *
choose only one
Will you be: *
please only choose one. If you plan on working while going to college choose the college option.
If you are entering the military what branch and date of entry?
Your answer
If you are working where are you working and what kind of work will you be doing?
Your answer
Name and Address of College/University/Institution *
if you are not attending school please write "not attending".
Your answer
If you applied through Common App, will you need a Final School Report Submitted?
List colleges you were accepted to:
this is for statistical purposes and no names are used
Your answer
If you have had any years of perfect attendance please indicate grade level(s):
Your answer
Scholarship Information
Write in the names of all scholarships that you have been awarded. Please list the total award amount for each scholarship. Designate which scholarship you will be accepting and which you have declined.

Please notify Mrs.McCreary in counseling if you receive additional awards after submitting this form or if you need more space.

Scholarship Title
List the full title and the name of the organization, person, or school that is sponsoring the scholarship.
Your answer
Total Award Amount
For scholarship listed above. Ex. $2,000 x 4 years or $8000
Your answer
Scholarship Status
Scholarship Title
List the full title and the name of the organization, person, or school that is sponsoring the scholarship.
Your answer
Total Award Amount
For scholarship listed above. Ex. $2,000 x 4 years or $8000
Your answer
Scholarship Status
How did the counseling department assist you during high school?
Your answer
How could the counseling department have helped you better
Your answer
What is your current employment status?
Your answer
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