Global Educational Assistance

1. Telephone Number: 

2. Mobile Number: 

3. Mailing Address  City:    

4. State or Province:    Zip Code: 

5. Email Address: 

6. Where do you most often access the internet? 

at home, 24/7 

upon demand, outside home  

paid access at internet cafe

7. High Schools Attended: 

8. What is your highest level of Math: Algebra   Algebra II    Calculus  Other

9. In what year did you or will you graduate high school?

10. Intended major in college: 

11. Intended college entrance date:  Fall Spring Summer  

12. Have you taken the SAT? Yes No  

If yes, when (month January February March April May June July August September October November December , year )

Scores:  M    V    Writing 

13. Are you scheduled to take the SAT?  Yes No  

    If yes, When ?

14. Have you taken the Act?  Yes No    If yes, when?       Composite Score

15. Have you taken the TOEFL? Yes No   If yes, when?

16. Score Computer-Based   Score Paper-Based 

17. Have you ever taken an SAT preparation course?  Yes No  

18. If yes, which one?

19. Which schools have you already applied to?

20. Which schools do you want to apply?

21. What is your first language?

22. What other languages do you speak?  Spanish    French    German   Greek    Other  

23. What language is spoken in your home?

24. If you are a female, do you prefer a female only section?  Yes No

25. How did you find out about our services?

26. Which competitive sports do you play? 

27. Do you compete nationally or internationally in sports? Yes No

28.  If so what is your ranking?

29. How can Global Educational Assistance help you? 

        College Applications  SAT Preparation    TOEFL Preparation 

        College Counseling    Translation   Transcript Certification

                                        All of the Above 

    By checking this box, I certify that all of the above information

    is true.  

 Name: 

   Signature Date:  Month: January February March April May June July August September October November December     Day:   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    Year:  

This information above will not be shared outside Global Educational Assistance without your permission.