Great Expectations Information Packet Cohort
Select your institution
Select your institution
Student ID # (optional)
Student ID # (optional)
Student Information
Student Information
Are you between the ages of 13 years and 24 years old?
Are you between the ages of 13 years and 24 years old?
Social Worker/Independent Living Coordinator Contact Information
Social Worker/Independent Living Coordinator Contact Information
What are your greatest challenges/needs as a student?
What or who helps you to be successful?
What are your plans after graduation?
What is your desired Program of Study in college or your desired career choice?
*If you are unsure of your plans or choices, please talk with your career coach, guidance counselor or Great Expectations advisor.
Permission for release of information
I give the Great Expectations Advisor permission to correspond, collaborate and exchange any information about my status with human services providers (i.e. dss), teachers, and instructors as the Great Expectations program deems necessary.

Please note that typing your name below establishes your agreemnt to use an electronic signature in lieu of a paper document with a traditional hand-written signature.  Your electronic signature will take place when you type your name into the appropriate signature area of the document and then click the submit button to indicate your agreement and/or authorization.
Signatures
Signatures