SAEP College Access and Success Advisors from our Upgrade Program are here to provide assistance to adult learners (18 & over) that have some college credit with returning to and staying enrolled in college. Advisors help with:
College Entry and Enrollment
Financial Aid Applications and Scholarships
Career Planning and Long-term Goals
Please complete the form with as much information as possible to help our College Access and Success Advisors be prepared for your advising session.
Please complete the statement for the service you are requesting:
Please select...
I would like to join and/or learn more about upgrade case management services.
I would like to request an advising session.
I walked into cafecollege for help.
VISIT INFORMATION:
How can we help you? Check all that apply.
Career Advising
College Application
Admissions Essay Revision
Financial Aid Advising
Financial Aid Application
Scholarships
Test Advising
Transfer Planning
Best time to contact
Please select...
8 am - 12 pm
12 pm - 4 pm
4 pm - 7 pm
Preferred Method of Contact
Please select...
Email
Phone
Text
What other questions do you have?
Limited to 225 characters
CLIENT INFORMATION
First Name
Middle Name
Last Name
Preferred Name
Preferred Pronouns
Preferred Language
Please select...
English
Spanish
Date of Birth
mm/dd/yyyy
Gender
Please select...
Male
Female
Non-Binary
Prefer Not to Say
Are you currently serving or have you ever served in the U.S. Military?
Please select...
Yes
No
Ethnicity
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African American
Alaska Native
Asian/Pacific Islander
Caucasian
Hispanic
Native American
Other Ethnic/Racial Heritage
Two or more ethnicities
Race
Please select...
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Two or more races
I prefer not to answer this question
CONTACT INFORMATION
Personal Email
Cell Phone Number
Street Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
MO
MA
MI
MN
MS
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ZIP Code
UPGRADE INTAKE INFORMATION
What information are you interested in?
Academic and Study Skills
Careers
College Selection
Credit for Work and Life Experience
Managing Outstanding College Debt
Navigating Campus Resources
Note-Taking Skills
Online Courses, Tips, and Degree Options
Paying for College
Reading Strategies
Success with Returning to College
Time and Stress Management Strategies
Transferring College Courses and Credits
Where Do I Start?
Writing an Academic Essay
Select all that apply
When do you want to start taking classes?
Please select...
ASAP
Within 3-6 months
Within 6-12 months
Next year
Unknown
Not Applicable (already enrolled in college)
How quickly do you want to graduate?
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Within 1 Year or 2 Semesters
Within 1-2 years or 3-4 Semesters
Within 2-3 years or 5-6 Semesters
Within 3-4 years or 7-8 Semesters
Within 5-6 years or 9-12 Semesters
More than 6 years
Unknown
How did you hear about us?
Please select...
Community Organization (Good Samaritan, Boys & Girls Club, etc.)
Employer
News/TV
Online Search (Google, Edge, Safari)
Parent/Family Member/Friend
SAEP Advisor
School
Social Media
Walk-In
What is your current employment status?
Please select...
Employed - 0 to 20 hours per week on average
Employed - 20 to 40 hours per week on average
Employed - 40+ hours per week on average
Not employed, but looking
Not employed, not looking
If employed, does your employer offer tuition benefits?
Yes
Company
Current Job Title
Please select...
Accountant
Account Executive
Administrative Assistant
Administrator
Archivist
Assistant Manager
Baker
Bartender
Billing Specialist
Bookkeeper
Business Analyst
Caregiver
Carpenter
Car Sales Agent
Casemanager
Cashier
Childcare Worker
Civil Engineer
Clerk
College Advisor
Community Health Worker
Compliance Officer
Computer Specialist
Construction Manager
Construction Worker
Consultant
Controller
Cook
Coordinator
Correctional Officer
Cosmetologist
Customer Service Representative
Data Analyst
Data Engineer
Data Entry Clerk
Delivery Driver
Dental Assistant
Dental Hygienist
Dentist
Dietician
Dishwasher
Dispatcher
District Manager
Doctor
Driver
Electrician
Equipment Operator
Executive Assistant
Farmer
Financial Advisor
Financial Analyst
Firefighter
Food Service Representative
Forklift Operator
Fraud Analyst
Front Desk Receptionist
Gardener
General Manager
Graphic Designer
Groundskeeper
Hairstylist
Home Health Aid
HR Manager
HVAC Worker
Industrial Engineer
Inspector
Insurance Agent
Intern
IT Specialist
Janitor
Lawyer
Legal Assistant
Legal Secretary
Librarian
Loan Officer
Machine Operator
Maid
Mail Courier
Maintenance Worker
Manager
Medical Assistant
Mover
Nursing Assistant
Office Assistant
Operations Manager
Paralegal
Patient Care Technician
Personal Assistant
Pet Groomer
Pharmacist
Pharmacy Technician
Phlebotomist
Pilot
Plumber
Police Officer
Pool Cleaner
Project Manager
Property Manager
Quality Assurance Analyst
Quality Control Specialist
Radiologist
Real Estate Agent
Receptionist
Recruiter
Registered Nurse
Registrar
Researcher
Retail Salesperson
Sales Associate
Salesperson
Sales Representative
School Counselor
Secretary
Security
Self-empoyed
Server
Site Director
Small Business Owner
Social Worker
Software Engineer
Specialist
Stocker/Order Filler
Substitute Teacher
Supervisor
Surgical Coordinator
Teacher
Teacher Aide
Teaching Assistant
Team Lead
Technical Support Specialist
Technician
Telemarketer
Teller
Travel Planner
Truck Driver
Tutor
Unemployed
Vehicle Servicer
Vet
Vice President
Volunteer
Waitress
Warehouse Worker
Wedding Planner
Welder
Other
Other Job Title
Are you a parent?
Yes
No
How many children do you have?
How old are your children?
Please select...
< 1 year
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21+
How many people are in your household?
What is your household's annual income level?
Please select...
Up to $24,000
$24,001 - $42,000
$42,001 - $56,000
$56,001 - $75,000
$75,001 or higher
P/G High School Diploma?
Please select...
Parent/Guardian Received a High School Diploma
Neither Parent/Guardian Graduated from High School
P/G College Degree?
Please select...
Parent/Guardian Completed College
Neither Parent/Guardian Completed College
Are you a dependent of a U.S. Veteran or current U.S. Military Member?
Please select...
Yes
No
Please tell us about your educational experience.
What is the highest level of education you have completed?
Please select...
Elementary School
Middle School
High School or GED
Technical or Occupational Certificate
Some College Coursework Completed
Associates Degree
Bachelors Degree
Masters Degree
Professional Degree
Doctorate Degree
What kept you from finishing your degree or certificate?
Academic Preparation
Different Learning Abilities
Finances
Fear of Failure
Fear of a Particular Academic Area
Family Responsibilities
Lack of Adequate Support Systems
Transportation
Unsure of Career Goals
Work Conflict
Other
Select all that apply
Do you currently have student loans in default?
Yes
No
Not Sure
How much do you owe on your defaulted loans?
Are you currently serving or have you ever served in the U.S. Armed Forces?
Please select...
Yes
No
Please provide the following information about your educational goals.
What type of credential are you seeking?
Please select...
Technical or Occupational Certificate
Associates Degree
Bachelors Degree
Masters Degree
Professional Degree
Doctorate Degree
Academic area of interest
Please select...
Accounting
Actuarial Science
Aerospace Engineering
African American Studies
Anthropology
Architecture
Art History
Automotive Technology
Banking & Financial Services
Biochemistry
Biology and Biomedical Sciences
Biomedical Engineering
Business & Management
Business Administration
Business Analytics
Chemical Engineering
Chemistry
Child Development
Civil Engineer
Communications
Computer Information Systems
Computer Science
Criminal Justice
Cybersecurity
Data Science
Data Analysis
Dance
Data Engineering
Dental Assisting
Drama & Theatre
Economics
Education
Educational Leadership
Electrical Engineering
Engineering
English
Environmental Science
Film & Media
Fire Protection & Prevention
Geography
Health
History
Hospitality & Event Management
Humanities
Information Technology
Interior Design
Journalism
Kinesiology
Language
Latin American Studies
Liberal Arts
Linguistics
Management
Manufacturing
Marketing
Mathematics
Mechanical Engineering
Medical Humanities
Multidisciplinary Studies
Music
Neuroscience
Nonprofit Administration & Leadership
Nursing
Nutrition
Pharmacy
Photography
Physics
Political & Criminal Science
Political Science
Pre-Law
Psychology
Public Administration
Public Health
Radio & Television
Real Estate
Social Work
Sociology
Spanish
Statistics
Supply Chain Management
Urban & Regional Planning
Visual & Performing Arts
Welding
Women, Gender, & Sexuality Studies
Sports/Recreation
Theology
Other
Preferred class format
Please select...
Accelerated
Online
In-person
Hybrid
Self Paced
Daytime
Evening
Weekends
What is the main reason you want to return to school?
Please select...
Personal Goal
Promotion
Required by Employer
Interested in Increasing Earning Potential
Interested in Career Change
Interested in Obtaining a Better Job or Promotion in My Industry
Personal Satisfaction
Other
ACKNOWLEDGEMENT
All information provided will remain
confidential within our organization. We respect your privacy, and we want to assure you that this information is only collected in aggregate so we can demonstrate to our donors what parts of the community we support through our free services. Your individual information will never be disclosed to outside parties. We appreciate your support as you consider providing the requested information.
Client Signature (Type your Name)
Today's Date
Please use MM/DD/YYYY date format.
Contact Information