Parent/Guardian
First Name
Last Name Phone Number
(XXX-XXX-XXXX)
( ) - -
Address City Zip
Information about your child
(use a separate questionnaire for each child):
Please enter your child's CPS ID
(Student ID Number found on their CPS ID card):
Student First Name Middle Name Last Name
Date of Birth (MM/DD/YYYY) School Grade (XX)

QuestionsOptions
Do you have questions about high school graduation requirements for your child?
Has anyone at your child’s school ever spoken with you about college entrance requirements?
Has anyone at your child’s school ever spoken with you about the availability of financial aid to help you pay for college?
Are you knowledgeable about financial aid and the cost and benefits of your child pursuing a postsecondary education?
Do you have enough information about applying for college?
Do you think it is Important for your child to go to college?
Are you aware that a high GPA could provide more college scholarship money for your child?
What is the highest level of education that you think your child will achieve?
What is the highest level of education of both parents?
a. Mother
b. Father
Do you think that your child could afford to attend a public 4-year college using financial aid, scholarships, and your family’s resources?
Are you interested in visiting college campuses with your child?
Would you like someone to contact you about preparing your child for college?