Intake Form | M State

First

Last

Address

Apartment

City/Town

State/Province

ZIP/Postal Code

Phone number

Student ID

Are you a

Are you planning to register as a

Major

Semester Starting

Are you taking classes

Financial Aid: I have completed my FAFSA

Financial Aid: I have started my FAFSA application and have questions

Career Counseling: I would like help exploring careers

Accessibility Resources: Would you like information on accessing accommodations for students with disabilities

Personal Counseling: I would like to learn more about M State’s counseling services

Tutoring & Study Support: I would like to learn more about M State’s academic support

Do you currently work?

Yes

If yes, how many hours a week during the semester do you plan to work?

If you are a Veteran, do you have tuition assistance or want to speak with someone about services available to you

Yes

Do you have needs in any of these areas?

Access to a computer

Childcare

Clothing

Financial

Food

Housing

Transportation

WiFi

Other

Please describe your "Other" needs