Sponsored By : Eastern Connecticut State University - QuestionPro Academic Sponsorship Programme
61%
Questions marked with a * are required Exit Survey
 
 
I. Student Information
 
 
* First name : 
* Last name : 
* Address Line 1 : 
   Address Line 2 : 
* City : 
    * State     * Zip Code
* Phone : 
* Email Address : 
 
 
* Eastern ID #
   
 
 
* Student Status
 
 
II. Academic Information
 
 
* High School Name
   
* City and State of High School
   
* Intended Academic Major
   
* Intended Occupation/Future Goals
   
 
 
 
SAT Verbal
   
SAT Math
   
SAT Writing
   
ACT Composite Score
   
 
 
 
Class Rank (if applicable)
   
Class Size
   
 
 
 
List major scholastic honors received
   
 
 
III. List Honors and AP Courses
 
 

   
 
 
IV. List significant extracurricular activities (e.g. leadership positions, community service, etc.)