The Harker School College Counseling Office
Junior Questionnaire
The Junior Questionnaire is designed for two reasons:
1.
To assist your college counselor in writing a letter of recommendation for you that will
be sent to every college to which you apply. It will also assist the counselors in filling
out questionnaires for college admissions and scholarship aid.
2.
To help you think seriously about yourself and your college options. An effective college
search must include an honest self-assessment. The more you know yourself, the better
you will be able to make important decisions about college.
Please Note:

Write as much as you would like. We would rather you write more than less.

If you prefer to type your responses, this questionnaire is available on the college counseling
webpage.

KEEP A COPY OF YOUR COMPLETED QUESTIONNAIRE. Many of these
questions are the same ones that will be asked by the colleges. By completing the Junior
Questionnaire, you are getting a head start on your college applications!
We will treat this questionnaire as confidential, and it will be available only to the College
Counseling Office.
We appreciate your cooperation!
Mrs. Padgett, Ms. Burrell, Mr.Walsh, and Mr. Lum Lung
THE QUESTIONNAIRE MUST BE COMPLETED AND
RETURNED TO MRS. HORIUCHI IN THE COLLEGE
COUNSELING OFFICE BY Tuesday, April 7th.
Harker College Counseling Office - Junior Questionnaire
Name: ______
Place of Birth: ______
Citizenship:
If not a U.S. citizen, are you a Perm. Resident? _____
Your E-mail address: _____________________
Your Cell phone #: ________________________________
Language(s) spoken at home:_______________
Other languages spoken or understood: ________________
Which grade did you enter Harker?
If not born in U.S., how many years in U.S.?
FAMILY INFORMATION
Father:
Mother:
Name:
Name:
Occupation:
Occupation
Company/Organization
Company/Organization
Undergraduate College
Undergraduate College
Graduate College
Graduate College
List your siblings and their ages:_______________________________________________________________
Is there anything unusual about your family (cultural background, shared interests, activities, travel, size, crisis,
etc.) that has shaped your own interests?
ACTIVITIES AND INTERESTS
In filling out the following section, include both Harker and non-Harker activities from the 9th grade and
after. Include 12th grade if you intend to continue your involvement as a senior.
Visual and Performing Arts – Music/Theater/Dance/Visual Arts Participation
Activity – List Music,
Theater, Dance, Art. Be
specific: list your
instrument, dance form, art
medium, etc.
Years Involved (9-12); Time Commitment
9 10 11 12 Hrs/
Weeks Productions you’ve been
week /Year
in; Organizations you’ve
performed with; Where
you’ve exhibited your
work
Honors, Awards earned
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Sports
Years you played (9-12), Time commitment,
List Sports Participation by
9
10 11 12 Hrs/
Weeks
Season
week /Year
Fall: (State if Varsity, JV or Club)
Leadership Positions
Varsity Letters Earned, Honors/Awards
Winter: (State if Varsity, JV, Club)
Spring: (State if Varsity, JV, Club)
Other School Activities – Yearbook, Newspaper, Clubs, etc.
Activity
Years involved (9-12), Time commitment,
9
10 11 12 Hrs/
Weeks
week /Year
Leadership Positions
Honors/Awards
Non-Harker Activities – Jobs, Religious, Community service, Hobbies, Personal Interests, Family, etc.
Activity
Years involved (9-12), Time commitment,
9
10 11 12 Hrs/
Weeks
week /Year
Leadership Positions
Honors, Awards
2
Summer Activities (employment, camps, summer school, programs, internships, etc.)
Name(s) of Activity. Be sure to include
the name of the sponsoring organization.
Provide a brief description of each activity
Summer after
9th Grade
Summer after
10th Grade
Summer after
11th Grade
(What do you
have planned?)
List any college classes taken for credit:
NAME OF COURSE
NAME OF COLLEGE
GRADE
REASON YOU TOOK THE COURSE
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Prizes/Awards/Honors (Academic, Leadership, Other). Specify if award was given outside of Harker.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
TELL US ABOUT YOURSELF
1. Tell us about something you do or an interest you have that most people probably do not know about.
(This is probably not something you have listed in the above Activities and Interests section—i.e. it is
not an organized activity or club.)
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2. According to Webster’s, a hobby is “something that one likes to do in one’s spare time.”
Colleges are very interested in learning about your hobbies. Describe your hobbies. Why do you do
them?
For example: “I have my own web design company, and...”
“I am a member of a garage band, and I write my own lyrics. Recently…”
“I have been studying Indian dance since I was five. I am getting ready to perform in…”
“I have always enjoyed working with young children, so every Saturday, I volunteer …”
“I spend my weekends rebuilding my car. I’ve become an expert in automotive…”
“I designed and built my own MP3 player. I did this because…”
YOUR ACADEMIC LIFE
1. What are your academic interests? Why are you interested in these areas?
2. Thinking about the academic interests listed in the answer to the above question, have you pursued these
interests outside of Harker in any way? How?
3. Tell us about a favorite academic moment or experience and why it is your favorite. (This could be a
class discussion you have had, a project you have worked on, a reading you have covered, an idea you
have pondered.)
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4. Please inform us of anything special that needs to be explained about your transcript, including the order
you took your courses, inconsistencies, skipping a level of language, advancing to a higher or lower
level class in the same year, receiving special permission to take a course, skipping a pre-requisite, and
auditing a course.
YOUR ASPIRATIONS
1. Which subjects do you hope to study in college?
2. Thinking about the subjects listed above, describe where these interests come from. How and when did
you first become interested in these subjects?
3. Describe your dream job. Where does this dream come from?
TELL US EVEN MORE ABOUT YOURSELF
1. What do you choose to learn about when you learn on your own? Consider, but don’t limit yourself, to
the following: a) your recreational reading; b) interests pursued beyond classroom assignments (though the
initial interest may have been sparked by a classroom assignment); c)topics chosen for research papers;
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2. Where have you traveled or lived that has had considerable influence on you? How did it influence you?
3. Describe a time you took a risk or stepped outside of your comfort zone. What did you take away from
this experience?
4. Are there any circumstances that have interfered with your high school academic performance?
Consider family problems, health problems, after school responsibilities, moving, cultural differences,
etc.
5. Is there anything else you would like the colleges to know about you? Think about what you would want
an admission officer at your top choice college to know.
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