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Name of Student: ______________________________ Grade Level/ Strand: _________________________

Contact #: _____________________________ Date: _________________

1. Are you planning to go in to college?

____ YesWhere?: ___________________________________________________________________________


____ No Why?: _____________________________________________________________________________

2. List down your course preference for college:


1 st choice: __________________________________ 2 nd choice: __________________________________________

3. What is your preferred school? Why?

______________________________ 1 st choice Reason(s): __________________________________________


______________________________ 2 nd choice Reason(s): __________________________________________
______________________________ 3 rd choice Reason(s): __________________________________________

4. Who will support your education in college?


____ Parents ____ Grandparents ____ Scholarship (please specify) _______________________
____ Siblings ____ Relatives ____ Others (please specify): ___________________________
____ Uncle/ Auntie ____ Self-Support Job

Name of Student: ______________________________ Grade Level/ Strand:


____________________________
Contact #: _____________________________ Date: ___________________

1. Are you planning to go in to college?

____ YesWhere?: ___________________________________________________________________________


____ No Why?: _____________________________________________________________________________

2. List down your course preference for college:


1 st choice: __________________________________ 2 nd choice: __________________________________________

3. What is your preferred school? Why?

______________________________ 1 st choice Reason(s): __________________________________________


______________________________ 2 nd choice Reason(s): __________________________________________
______________________________ 3 rd choice Reason(s): __________________________________________

4. Who will support your education in college?


____ Parents ____ Grandparents ____ Scholarship (please specify) ________________________
____ Siblings ____ Relatives ____ Others (please specify): ____________________________
____ Uncle/ Auntie ____ Self-Support Job

Name of Student: ______________________________ Grade Level/ Strand:


____________________________
Contact #: _____________________________ Date: ___________________

5. Are you planning to go in to college?

____ YesWhere?: ___________________________________________________________________________


____ No Why?: _____________________________________________________________________________

6. List down your course preference for college:


1 st choice: __________________________________ 2 nd choice: __________________________________________

7. What is your preferred school? Why?

______________________________ 1 st choice Reason(s): __________________________________________


______________________________ 2 nd choice Reason(s): __________________________________________
______________________________ 3 rd choice Reason(s): __________________________________________

8. Who will support your education in college?


____ Parents ____ Grandparents ____ Scholarship (please specify) ________________________
____ Siblings ____ Relatives ____ Others (please specify): ____________________________
____ Uncle/ Auntie ____ Self-Support Job

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