Academic Consulting
www.academicconsulting.biz
Coaching Acceptance Form
You are just a few steps away from getting your own personal academic strategic plan that can provide you lasting change in the way to learn and perform academically. In order to do this, you need to fill out the following form. By thinking carefully about your answers and taking the necessary time to complete the following information as accurately and clearly as possible, you will benefit greatly by giving us a clearer picture of the real issues you face.
Please answer the information below: (Please note that all information is strictly confidential)
Disclaimer: Applicants are carefully selected based on their committment to succeed and their level of motivation to excel. We reserve the right to accept students based on these factors alone.
About Yourself
1. Your full name:
2. Why do you think you are not achieving the academic perfromance that you want? Please be as specific as possible.
3. What would be your ultimate goal for your academic situation? (E.g. get a 4.0 GPA have more time to myself, etc...)
4. How would this make you feel if you achieved the above? Please be as detailed as possible here.
5. What would be the ultimate life you would like to lead after you graduate? Please consider factors such as the kind of income would you like to make, what your dream job would be, where would you like to live, etc...
6. Can you see how your academic performance will help you achieve this ultimate life? If you can't, what do you think will help you obtain this lifestyle?
How you spend your time?
1. Are you on time for your classes?
2. How do you spend your time before your class?
3. How do you spend your time after class?
4. Do you use a day planner or scheduler at all?
5. Do you use a large wall calendar?
What you do in class (how effective you are)
1. Where do you usually sit in class?
2. When you are in class, what goes on during these classes?
.
a. Are you distracted? If so why do you think this happens? b. Do you have trouble understanding the concepts discussed in class? If so please explain why. c. Do you find that you have trouble taking notes? If so please explain why. d. Please indicate anything else that goes on in class that may affect your performance.
Social Activities
1. What activities and tasks give you energy and revitalize you?
Level of Committment
1. Are you willing to committ yourself to gett the grades that you want?
2. Are you able to commit to a personalized coaching program at the above rate if you are accepted?
3. How did you hear about Academic Consulting?
Contact Information
1. Email address:
2. Phone number:
3. Year of study and school:
Thank you!
www.academicconsulting.biz
(E.g. 3rd year student at the University of Calgary)
