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University of Wyoming

Career Counseling Intake Form

Please complete this form prior to your initial phone appointment.

Who is Your Career Counselor?
 

Your Information
First Name:
Last Name:
Age:
Current Address
Street or Box Number:
City:
State:
Zip:
Telephone:  -  - 
Email:
If Applicable
Class Standing:
        Freshman Sophomore Junior Senior
        Graduate UW Employee Other
Current College Enrollment:
        Undeclared Agriculture Arts & Science Business
        Education Engineering Health Science
Current Official Major:
Current Advisor:
How Did You Learn About Our Services?
Friend University Studies Class RA/Hall Pres. CACS
Other Advisor SEO Parents Instructor
Counselor Branding Iron Postcard Phone Book
Other (Please describe)  

All the information you share with CACS is treated as confidential. It may be necessary for your career counselor to confer with other CACS staff, including your advisor in order to provide you with the best possible service and it may occur that information gathered from your career counseling may be anonymously used for purposes of researching with the goal of improving services for all students.
Have you have read and do you understand the above statement?