Pathways College Connections Application (Student)

Email Address

First Name

Last Name

Mailing Address

Country

Street

City

Region

Postal Code

Birthdate

Phone

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 1 Mailing Address (if different than student's)

Country

Street

City

Region

Postal Code

Parent/Guardian 1 Phone

Parent/Guardian 1 Alt Phone

Parent/Guardian 1 Email

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Mailing Address (if different than student's)

Country

Street

City

Region

Postal Code

Parent/Guardian 2 Phone

Parent/Guardian 2 Alt Phone

Parent/Guardian 2 Email

Please share with us the name and contact information of a reference. This individual will need to be from high school and can be a special education teacher, case-manager, social worker or counselor.

School Reference First Name

School Reference Last Name

School Reference Email

School Reference Phone Number

Those who participate in the Pathways College Connections program should have NO KNOWN incidents or threats of self-harm, or threats or acts of aggression or violence towards others in the past three years.

The following questions were designed to help the Aurora University Pathways team get to know you better. There are no right or wrong answers. Please take time to answer honestly. Thank you!

1. Do you receive any helpful classroom supports in your current school? Please explain why these are helpful for you.

2. What, if any, sports, clubs, extracurricular activities, or hobbies do you participate in?

3. What do you do when you need help with something at school? How often do you reach out to others for support, and who are you most likely to reach out to? If you don’t typically reach out to others, please explain why.

4. Right now, how interested are you in attending college in the future

Not at all interested

Somewhat Interested

Very Interested

Definitely Interested

4. Right now, how interested are you in attending college in the future

5. If you do decide to attend college, what major(s) are you interested in?

6. What type of job or career would you like to have after high school or college?

7. How do you spend time socially now? Do you have a group of friends, or a close friend? What do you typically do together?

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