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STUDENT PROFILE

STUDENT NAME*
First Name Last Name

Nickname Gender or Preferred Pronouns

D.O.B.* Mobile #* Email*

DD/MM/YYYY

High School* Current Grade* Grad Year*

Intended College Start Year*

Student Living With □ Parent 1 □ Parent 2

Whom may we thank for referring you?

GENERAL CLIENT INFORMATION

PARENT 1* Occupation
First Name Last Name

Mobile #* Email*

Address* City* State* Zip*

PARENT 2 Occupation
First Name Last Name

Mobile # Email

Address City State Zip

SIBLINGS

SIBLING NAME GRADE HS GRAD YEAR COMMENTS

1.

2.

3.

4.

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STUDENT ACADEMIC INFORMATION

Guidance Counselor Name

□ Same high school all four years? If no, explain*

GPA

Academic Weighted* Academic Unweighted*

10-12 Weighted* 10-12 Unweighted*

Total Weighted* Total Unweighted*

Class Rank

Strengths Weaknesses

Likes Dislikes

STUDENT NEEDS (e.g., Learning Differences, Physical Impairments, etc.)

SPECIAL CIRCUMSTANCES (e.g., Parent Job Changes, Relocation, etc.)

OTHER NOTES

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COLLEGE ENTRANCE EXAMS*

PSAT Date Taken Score □ National Merit Scholar?

SAT Date Taken Composite Super Score

Reading/Writing Math Essay

Additional SAT Sittings/Scores

PACT Date Taken Score

ACT Date Taken Composite Super Score

English Reading Science Math Writing Composite

Additional ACT Sittings/Scores

TEST PREP

Future TEST Plans? If so, which test & when

Test Prep Already Completed/In Progress

Future Test PREP Plans

AP TESTS (Already Taken and Planned)*

Subject Date Score
Subject Date Score
Subject Date Score
Subject Date Score
Subject Date Score
Subject Date Score
Subject Date Score
Subject Date Score

CAREER ASSESMENT

School Uses Naviance? □ Y □ N □ Don’t Know Myer’s Briggs 4 Letter Personality Type

Major in Mind Career in Mind

□ No Idea/Please Help!
If a major is noted above, why this major/career?

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Cornerstone College Planning [Link]
(949) 391-2575

EXTRACURRICULAR ACTIVITIES Leadership Years/Grades

Sports □
Music □
Marching Band □
Dance □
Theater □
Community Service □
Other □
Other □
Other □

ANYTHING ELSE YOU’D LIKE US TO KNOW?

PRELIMINARY COLLEGES OF INTEREST

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