Student Intake Form – HelpConsult

Please select your package:

Bronze Package – Foundation Support Silver Package – Application & Aid Planning Gold Package – Full-Service Admissions & Transition

Optional Add-Ons:

Additional Essay Review – $50/essay Mock Interview – $75/session Hourly Consultation – $100/hr Gap Year Consultation- $50/ 30-minute session

Cumulative GPA (Unweighted):

Standardized Tests Taken (check all that apply):

AP/IB Courses Taken:

Anticipated Major(s) or Career Interests:

Colleges You’re Considering (if known):

College Prep Areas of Interest

Availability for Meetings

Zoom In-Person

Best days/times to meet (check all that apply):

Weekdays (Morning) Weekdays (Afternoon) Weekdays (Evening) Saturdays

Billing & Payment Information

You will receive an invoice after your intake form is reviewed. Payment options include:

Billing & Payment Information

Credit/Debit Card Paypal Zelle Are installment plans available for the Gold Package upon request?

Would you like to request a payment plan?

Yes No

Consent & Agreement

By signing below, I acknowledge that I have selected the above services and understand the scope of the package. I agree to communicate any scheduling conflicts in advance and understand that unused sessions are non-refundable but may be rescheduled.

In-Take Form

In-Take Form

Parent/Guardian Contact (if applicable)

Service Selection

Academic Snapshot

Billing & Payment Information

Consent & Agreement

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