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* Student Local ID

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* Student Name:

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* 1. What program are you a part of at DeSoto High School?

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* 2. What is your gender?

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* 3. What ethnic background do you identify with?

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* 4. What is your current grade level?

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* 5.  How long have you been in your present home?

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* 6.  Who lives with you at your current address?

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* 7.  Did any of your family members attend college and receive a college degree?

  Yes No
Mother or female guardian
Father or male guardian
Brother(s) or Sister(s)
Grandparents(s)

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* 8.  How would you rate the need for education beyond the high school level?

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* 9.  What is the highest level of education that you expect to obtain?

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* 10.  Do your parents want you to graduate from high school?

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* 11. Do your parents want you to go to college?

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* 12.  Are you familiar with the entrance requirements for the following institutions?

  Yes No
Career or vocational training
Two-year public college
Four-year public college or public university
Four-year private college or private university

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* 13.  Which of the following will motivate you to attend college in the future? (check all that apply)

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* 14.  Which of the following would prevent you from attending college? (check all that apply)

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* 15.  Only answer if you do not plan on attending college*  Which of the following would help you make a decision on attending college? (check all that apply)

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* 16.  Has anyone from your school or GEAR UP ever spoken with you about college entrance requirements?

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* 17.  Has anyone from your school or GEAR UP ever spoken with you about the availability of financial aid to help you pay for college?

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* 18.  Do you think that you could afford to attend a public 4-year college using financial aid, scholarships, and your family’s resources?

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* 19.  Who gives you information about continuing your education after high school?
      (check all that apply)

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* 20.  Select two career pathways that interest you the most.

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* 21.  Are you familiar with the financial aid available for college?

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* 22.  If you plan to apply to a college or university, do you know what steps to take to apply successfully?

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* 23.  If you plan to apply for financial aid, would you need assistance with the application?

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* 24.  Do you agree with the following statements?

  Yes No
My family and I believe it is important to save money to prepare for college
My family and I started saving money in preparation for college
My family and I know the steps to prepare and save money for college
If made available, my family and I would attend training on how to prepare to save money for college
My parents have a bank account (checking or savings)

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* 25.  Do you think it is important to save money for college?

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* 26.  Do you believe it is important for your parents to save for your college?

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* 27.  Are you knowledgeable about financial aid and the cost and benefits to you of going to college?

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