The following form should be filled out if you are requesting a no-fee phone consultation.
Please provide information that is accurate to the best of your knowledge so we can better serve you. This form must be postal mailed or emailed in a copy/paste procedure to cacsmpls@comcast.net.

Basic Information:

Today's Date:

Student's Name:

Student's Email Address:

Parent's name:

Parent's Email Address:

Parent's Marital Status (Married, Re-married - include date)

Divorced (include date):

Single:

Address: City:

State: Zipcode:

Parent's Name:

Parents Phone: (home)(work)

(cell)

Academic Information (High School):

Academic status:

High School:

Date of graduation:

High school G.P.A.:

College entrance exam scores: P.S.A.T. S.A.T.
A.C.T.

College Information:

Please list your top six college choices starting with number one as being your top choice:

Do you have any siblings in college?

If yes, please list their classification/status in college:

Have you already applied for financial aid?

Household Information:

Parent's marital status:

Father's name:

Mother's name:

Age of oldest parent:

Number of household members:

Number of siblings (not including you) in: 1st-8th grades: 9th grade: 10th grade: 11th grade: 12th grade:

Private school tuition amount being paid (per year): $

How did you learn about us?

Any additional comments: