Senior Questionnaire 2019

	From which Iredell Statesville High School will you graduate?*
	From which Iredell Statesville High School will you graduate?* Lake Norman High North Iredell High South Iredell High Statesville High West Iredell High CCTL Monticello School Springs Academy Career Academy and Technical School Crossroads

	Student's Last Name*

	Student's First Name*

	Student's Middle Name

	Student's ID Number*

	Student's Gender*
	Student's Gender* Male Female

	Student's Birthday mm/dd/yyyy*

	Student's Ethnicity
	Student's Ethnicity American Indian/Alaskan Native Asian/Pacific Islander Black Hispanic Multi-Racial White

	Student's Street Address*

	City*

	State*

	Zip Code*

	Student Cell Phone Number

	Student's Personal Email Address

	Education/Career Plans* What are you doing after high school graduation?
	-- Please Select --Public Four Year College in NCPublic Four Year College outside of NCPrivate Four Year College in NCPrivate Four Year College outside of NCCommunity/Technical College in NCCommunity/Technical College outside of NCPrivate Two Year College in NCPrivate Two Year College outside of NCApprenticeshipMilitaryEmployment

	If you are planning to attend a 2 year Community College/Technical College, are you intending to:*
	-- Please Select --complete a technical degree programcomplete an associates degree programtransfer to a public 4 year college in NCtransfer to a public 4 year college outside NCtransfer to a private 4 year college in NCtransfer to a private 4 year college outside of NCNot planning to attend a 2 year community or technical college

	If entering workforce, please enter name of your employer.

	If entering workforce, please specify your job title.

	If entering military, please give branch of service.
	If entering military, please give branch of service. U.S. Army U.S. Navy U.S. Air Force U.S. Marines U.S. Coast Guard Army National Guard Air National Guard Merchant Marine

	Of the colleges to which you have been accepted, which one will you attend? This is the college to which we will send your final transcript.

	What is your intended college major?

	Please list all other colleges that have accepted you as an incoming freshman.
	College Second Choice   College Third Choice   College Fourth Choice

	Please indicate below any athletic scholarship and the dollar amount that you have been offered. Indicate whether you will accept or decline this offer.
	Athletic Scholarship #1   Athletic Scholarship #2

	Enter information below regarding academic scholarships you have been offered. Please indicate the name of the scholarship, the dollar amount, is the scholarship renewable or one time and whether you will accept or decline the scholarship offer. Do not include need based grants or athletic scholarships. If you have more than four scholarships, see your guidance counselor.
	#1 Name   #1 Dollar Amount   #1 Renewable or One Time   #1 Accept or Decline

	Enter information regarding your second academic scholarship.
	#2 Name   #2 Dollar Amount   #2 Renewable or One Time   #2 Accept or Decline

	Enter information regarding your third academic scholarship.
	#3 Name   #3 Dollar Amount   #3 Renewable or One Time   #3 Accept or Decline

	Enter information regarding your fourth academic scholarship.
	#4 Name   #4 Dollar Amount   #4 Renewable or One Time   #4 Accept or Decline