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Parent Initial Evaluation Application
Hi, PREP Client! Please complete this survey so that we may begin crafting a customized educational plan for your student and you!
#GetPREP
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* Required
Date
MM
/
DD
/
YYYY
Your email address
*
Your answer
What is/are your student(s)' name? (First, then last for all)
*
Your answer
Name (First, then last)
*
Your answer
Address (street, city, state, & zip)
*
Your answer
Phone Number
*
Your answer
What is your preferred way to contact you?
*
Email
Text Message
Phone
When are your preferred days to meet or video conference?
Select Two
Monday
Tuesday
Thursday
Friday
Saturday
Sunday
Select Two
Monday
Tuesday
Thursday
Friday
Saturday
Sunday
Marital status?
*
Single
Divorced
Married
Widow/Widower
Are/were you or the other parent in the military?
*
Yes
No
If so, has the GI Bill funding been used at all?
Yes
No
Not sure
Clear selection
Employment Status?
*
Work for an organization or company
Self-Employed
Unemployed
Unemployed due to disability
What type of education has/did/will your student receive after 7th grade?
*
public education
charter school
private school
home school or online
How many students (7th gr & up) are in your household?
*
1-2
3-4
more than 4
What is your relation to your student?
*
Parent
Legal guardian
grandparent
Other family member
What gender is your student?
Female
Male
Prefer not to say
Child 1
Child 2
Child 3
Child 4
Female
Male
Prefer not to say
Child 1
Child 2
Child 3
Child 4
What grade range(s) is/are your student(s)?
*
7th - 8th
9th - 10th
11th (junior)
12th (senior)
Required
Does/did your student receive free or reduced lunch?
*
Yes
No
Not sure
Does your child have learning disability that identified in an IEP (Individual Education Plan)?
Yes
No
Clear selection
What is your highest level education?
*
High School grad/GED
Some college credit/experience
Associate's Degree
Bachelor's Degree
Graduate degree (Master's or higher)
Are you familiar with how to apply for college?
*
Yes
No
Somewhat
Are you familiar with the college financial aid process?
*
Yes
No
Somewhat
Do you know which college your student wants to attend after high school?
*
Yes
No
Not sure
Which type of college/university do you prefer your student to attend right after high school?
*
public/state college/university
Private college/university
Junior/community college or trade/art school
No preference
Which specific type of college?
*
Historically Black College/University (HBCU)
Religious
Hispanic Serving Instiution
Tribal College
Predominantly White Institution (PWI)
No preference
What size college do you prefer?
*
Small (less than 2,000)
Mid-size (2,100 - 6,000)
Large (6,100 and 15,000)
No preference
Very Large (15,100
Which college entrance exam has your student taken?
*
PSAT
SAT
ACT
N/A (too young)
Has not taken, but needs to this year
Do you know how your student plans to help change the world (career)?
*
Yes
No
What is your student(s)' talent (besides sports)?
Select One
Music (vocal or instrumental)
Art (visual, including photography)
Theatre
Engineering (puts things together easily)
Dance
Organization
Writing (creative or technical)
Not sure
Select One
Music (vocal or instrumental)
Art (visual, including photography)
Theatre
Engineering (puts things together easily)
Dance
Organization
Writing (creative or technical)
Not sure
Does your student play organized sports?
*
Yes
No
If so, which sport(s)?
Select all that apply
Basketball
Football
Softball/Baseball
Soccer
Cheerleading/Dance Team
Tennis
Track & Field
Volleyball
Golf
Select all that apply
Basketball
Football
Softball/Baseball
Soccer
Cheerleading/Dance Team
Tennis
Track & Field
Volleyball
Golf
What is your student(s)' GPA?
*
below 2.0
2.1 - 2.5
2 6 - 3.0
3.1 - 3.7
3.8 - 4.0
Is your student in the Junior National Honor Society or National Honor Society?
*
Yes
No
Not sure
Name any other organization(s) in which your student participated. For example, school clubs, social club proteges, church committees, etc. (This is for scholarship opportunities. Must provide proof.)
Your answer
Does your student volunteer or do any community service?
*
Yes
No
Not sure
What is your location preference for your student(s) college?
*
In-state
Out-of-state
Local (within 50 miles)
No preference
International (study abroad)
What is your level of comfort about college planning?
*
Not comfortable (fish out of water)
1
2
3
4
5
Very comfortable
What are your needs for The PREP Factory?
Select One
I am inexperienced, don't know where to start
I have no time
I want to explore all options
College planning is intimidating
Select One
I am inexperienced, don't know where to start
I have no time
I want to explore all options
College planning is intimidating
Clear selection
What is your student(s)' and your greatest need?
Choosing/applying a college (including financial aid & housing)
Scholarship searching
Picking a career/mentoring
College testing
Academic readiness
Athletic recruiting
Retention (making sure they graduate)
We need help overall
Clear selection
How did you hear about us?
*
Met a staff member
Referral
My student
Social media
Internet search
What is your level of comfort with using technology?
*
Not very comfortable
1
2
3
4
5
I am a pro
Have you been able to save money for your student(s)' college education?
*
Yes
No
I have saved a little
Would you attend our college planning workshops?
*
Yes
No
Maybe
Name a workshop you would be interested in attending.
*
Your answer
How committed are you to the college planning process?
*
I have a lot going on
1
2
3
4
5
I am very committed
The PREP Factory's process (digital binder) is proprietary. Will you remain confidential about it?
*
Yes
No
Maybe
Are you ready to #GetPREP?!
*
Yes, right now!
Yes, but in a couple of months.
No, I am still researching.
Not yet, but invite us to your workshops!
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