Graduate Philadelphia Intake Form

Graduate Philadelphia supports adult learners returning to learning who are interested in obtaining postsecondary credentials that include certificates, industry certifications, micro-credentials, and services through to college completion. Graduate Philadelphia's signature Career Integrated Learning Advising (CILA) services are designed to support you with your learning and career needs.

Since 2008 we have helped thousands of adult learners who started their degree but never finished or have been interested in returning to learning.  Our services also include a focus on career and professional development. Thanks to the generosity of funders and partners, our services are offered at no cost to you. 

To get started fill out the questionnaire below so that we can better serve you. This form will take you 5-10 minutes to complete and will allow us to tailor advising services to your individual needs. Please note that we will never sell your information.  After you submit the form, one of our advisors will contact you about next steps.   

Call us at 215.933.2139 or email us at if you have any questions.

Congratulations on already taking your first step!

The Graduate Philadelphia Team

First Things First...

First letter must be uppercase

First letter must be uppercase

Your email will be used to contact you for advising. You will also receive occasional newsletters, information about opportunities for Comebackers like you, requests to update your information in our records.  You will always receive opt-out options for all. 

If an error occurs, please call us as 215-933-2139 or email

Receiving text  messages is a great way to receive useful information and to stay in touch with your Graduate! Philadelphia advising team.  Text messages will consist of information on upcoming events, information verification, and/or appointment reminders.  Graduate! Philadelphia will generally not send text messages more than once per week unless you request a return text message.  You will be able to opt out of receiving text messages at any time by replying with the word "STOP". 

The following information is considered confidential by many people. We are concerned with your privacy as well. Please know that this information is used only in aggregate, for fund-raising purposes, so that we may continue to provide our services for free. We appreciate your support as you consider providing the requested information.

Employment and Prior Debt

Please tell us a little about your educational experience...

If not listed, see "Other College #1" box.

Put all your dates in the format: MM/dd/yyyy

If not listed, see the "Other College #2" box.

If not listed, see the "Other College #3" box.


... and your educational goals

By submitting this form I give permission to Graduate! Philadelphia to forward my information to its partner institutions for purposes of assisting with my college admissions/enrollment.

I give permission to the Admissions/Office of Enrollment Management/Registrar of the College/University I shall be attending to release to Graduate! Philadelphia information verifying my enrollment status and my official transcript.

I fully understand that all information given on this application and information released to Graduate! Philadelphia or its partner institutions is protected by the Federal Privacy Act and, therefore will be kept confidential.  Graduate! Philadelphia promises it will NEVER sell or give away personal information.

I certify that all information that I have provided on this application is accurate and true to the best of my knowledge and ability.

If you have questions now or later, please contact our advisors: 215.933.2139 or