Spartan Connect

First name

Last name

Preferred Phone number

Student ID

Which statement best describes your language background?

I am a native speaker of English or fluent in English

I am learning English and would like to improve my English

My home campus is

Detroit Lakes

Fergus Falls

Moorhead

Wadena

Online

I will be a student athlete on the Fergus Falls campus

Yes

I plan to work while taking classes

No, I will not be working

Yes, part-time

Yes, full-time

Are you planning to register as a

My preferred course schedule is

8AM - 1PM

1PM - 6PM

6PM - 9PM

Major

Semester Starting

How do you plan on taking classes

I have submitted my FAFSA

I have Financial Aid questions

I had an IEP or 504 Plan in high school

Career Counseling: I would like help exploring careers

I would like to learn more about tutoring and study support

I have questions about my eligibility to use veteran benefits

Yes

I have needs in these areas

Please rank your needs on a scale from 1-5.

1= I'm good
3= Okay for now, might need help in the future
5= Help now!

Questions	1	2	3	4	5
Access to a computer	1	2	3	4	5
Childcare	1	2	3	4	5
Clothing	1	2	3	4	5
Financial	1	2	3	4	5
Food	1	2	3	4	5
Housing	1	2	3	4	5
Mental health	1	2	3	4	5
Transportation	1	2	3	4	5
WiFi	1	2	3	4	5
Other	1	2	3	4	5

Please describe your "Other" needs