Initial Consultation Form (updated 19.7.17)
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Initial Consultation Form
Student Name
*
First Name
Last Name
Date of Birth
*
School
*
Curriculum
IB
AP
A-Levels/IGCSE
Other
Grade / Year
*
Grade 12 / Year 13
Grade 11 / Year 12
Grade 10 / Year 11
Grade 9 / Year 10
Grade 8 / Year 9
Grade 7 / Year 8
Grade 6 / Year 7
Year of University Application
*
This Year
End of 2018
End of 2019
End of 2020
End of 2021
Other option
Citizenship
*
Thai
Other option
Siblings
Yes
No
Student Phone Number
Student Email
*
Skype ID
Mother - Name
*
First Name
Last Name
Mother - Phone Number
*
Mother - Email
*
Father - Name
*
First Name
Last Name
Father - Phone
*
Father - Email
*
Residential Address
Target Study Location for College
*
United States
United Kingdom
Other option
Target Universities
*
Intended Course(s) of Study
*
Subjects Taken This Year
*
Best Subject(s)
Favorite Subject(s)
Worst Subject(s)
Least Favorite Subject(s)
Academic Information
:
(Please only fill it in if you have taken the test)
SAT I
ACT
SAT II
Extracurricular and Work Experience (e.g. instrument, sport, internship)
*
Major Awards
Please upload your latest academic transcript.
Please upload your latest resume.
Any other comments or questions you would like to ask:
Submit
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