Great Neck South High School



Great Neck South High School

Guidance Counselor Questionnaire Form

Name_____________________________________________________________________

Counselor________________________Student Email _____________________________

1. Personal Background

Place and date of birth:

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Previous school:

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Parents background/careers:

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Siblings (ages, genders):

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Languages spoken at home:

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2. List the clubs, publications, and sports teams in which you have participated in school.

Freshman Year:

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Sophomore Year:

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Junior Year:

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Senior Year:

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3. List all activities in which you have participated outside of school.

Be sure to give dates of participation for each activity listed.

Jobs:

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Sports:

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Volunteer Work:

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Clubs, religious organizations, etc.:

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Travel:

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Other summer experiences:

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Take time in organizing the wording of your responses to the following questions, as they may be

quoted. Provide specific examples with details to provide your colleges with a concrete picture

of you and your interests, talents, and goals. Remember to be concrete and to supply details

but also to avoid repeating yourself.

4a. Describe your character—in your own words, in those of others who know you well,

and/or through a personal motto.

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4b. Describe your interests, talents, hobbies, etc. Include how you’ve been developing

them over the years.

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5. What are your academic strengths and/or interests? What have you done, inside and

outside of school, to pursue these?

Include specific projects, papers, outside reading, honors, awards, AP courses,

college courses, summer programs, internships, etc.

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6. Of the activities listed in questions 2 and 3, what have been most meaningful? Why?

Describe any leadership positions and /or contributions you have made. Be specific

about your responsibilities and the amount of time you have committed to each activity, etc.

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7. What special circumstances or influences have affected your academic record in a

positive or adverse way? For example, discuss travel opportunities, recent immigration,

illness, and family situations.

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8. Describe an experience that has been meaningful to you.

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9. What are your long-term goals and/or career plans? What steps have you taken so

far to pursue long-term goals and/or career plans?

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