UNIVERSITY COUNSELLING OFFICE

STUDENT QUESTIONNAIRE – FOR STUDENTS ENTERING

YEAR 11 (CONFIDENTIAL)
Career Studies Assignment
Please submit to your Brightspace Career Studies course by
Monday, September 13, 2021 at 8:30am

Full Name:
20ha:S Pervez
______________________________________________________
___________________
First ​ ​ ​ ​ Middle ​ ​ ​ ast
L

Zo hair
Preferred first name: ___________________________ House:
McHugh's
_______________________________

15/11/2005
Date of birth: ________________________ Citizenship (list
all):______________________________
Month ​ ​ ay
D ​ ear
Y

Please answer ALL the questions thoughtfully and with candour.

We need this information in order to help you plan your post-
secondary applications. Your replies are confidential.

Education:

2019
When did you enter UCC? (Include the Prep) _____________ 9
​Grade Level at entry ______
Year
Which school(s) did you attend prior to UCC?

Olive Grove
Name: __________________________________School Mississauga
City: _________________ Grade Level(s):
_____
Janet McDougald PS Mississauga
Name: __________________________________ City: _________________ Grade Level(s):
.

_____

Which subject(s) did you enjoy the most prior to Year 11? Why?
_______________________________________________________
Science I've
'

Always Enjoyed learning

____________________________
.

the way things work in our bodies

_______________________________________________________
____________________________ ,

around Us , In chemicals, etc

_______________________________________________________ .

____________________________

_______________________________________________________
Math : New
Learning
____________________________ ways to do
New things enlighten me and allow
_______________________________________________________
____________________________
to
me
gain an appreciation for things that
_______________________________________________________
____________________________
I Didn't know Before
_______________________________________________________
____________________________
.

_______________________________________________________
____________________________
_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
____________________________
_______________________________________________________
_________________________

Which one(s) have you found the most challenging? Why?

_______________________________________________________
French : specifically
____________________________ I am not
_______________________________________________________
to learn
languages It
____________________________
one new
.

takes A lot of Time and effort for

_______________________________________________________
____________________________
me to ream
languages
_______________________________________________________
________________________
.

_______________________________________________________
_______________________________________________________
_______________________________________________________
_

_______________________________________________________
_______________________________________________________
_______________________________________________________
_

_______________________________________________________
_______________________________________________________
_______________________________________________________
_
_______________________________________________________
____________________________
On what types of assessments do you feel you perform best? (Where
appropriate, check more than one)​

Exams ​

É
Tests
Essays
Projects
Presentations
Discussions In English
Other (specify):
________________​

How do you learn best? (Where appropriate, check more than one)​
Lecture ​ Reading
-Small group discussion -One-on-one Other
(specify): ____________________

On average, how many hours do you spend on school work outside

of class time?

1- 2 hours
Each school day: _________ ​ ​Each weekend: 1- 3
_________ hours

What do you consider to be your most significant academic

achievement thus far? Why?
8 in Math
Getting
_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
____________________________

_______________________________________________________
____________________________

Please describe any outside circumstances (including, but not

limited to, COVID’s effects) that have negatively affected your
academic performance.
_______________________________________________________
Covid : Time Management
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
___________________________

Activities and Interests:

List your main extracurricular interests and activities and years of

involvement (including those you plan to start in Year 11). These
should include the things you do both inside and outside of UCC.
Once complete, please rank your entries in order of their
importance to you.

Activity UCC Non- Type of Involvement/Position/Duration Y8 Y9 Y10 Y11 Ra

UCC nk

Horizons x Tutor, School Year x x x 2

Example
Baseball x x Pitcher, Captain, Spring term & Summer x x x 3 s

Key Club x Treasurer, All Year x 1

Hockey ✗ Center xx ✗ 1
BIFF ✗ For fun ✗ ✗✗ ✗ 2

What have you gained or learned as a result of your involvement in

these activities? Be specific.
_______________________________________________________
Physical Strength ,
____________________________ Agility
_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
______________________

List any of these types of activities (or others) you plan to pursue
after high school.
_______________________________________________________
Football , Hockey ,
____________________________ volunteering wook
_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

How did you spend your last two summers?

_______________________________________________________
Vacation Netflix
, Physics
____________________________
, ,

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

What aspects of your high school experience have you enjoyed the
most? And the least? Please explain why in each case.
_______________________________________________________
Networking with others and
____________________________
-

Socialising
_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
_______________________________________________________
_____________________________________________________
_______________________________________________________
__________________________

What do you consider to be your most significant contribution to the

UCC community? Why?
_______________________________________________________
NIA
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
______________________________
 ​
Which adults, including teachers, have influenced you the most, and
how?
_______________________________________________________
Mother , Father Advisor
____________________________ ,

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
__________________________
_______________________________________________________
____________________________
_______________________________________________________
____________________________
_______________________________________________________
____________________________
_______________________________________________________
____________________________
What has been your most remarkable life experience? How has this
shaped or influenced you?
_______________________________________________________
Getting Into Ucc , It has
____________________________ helped Me Manage My
time better
_______________________________________________________
.

____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
____________________________
_______________________________________________________
____________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
______________________________
Your Post-Secondary Plans:

It is important to know WHY you want to pursue a post-secondary

education. In considering your goals for that time, rank the
following values from 1 (the most important to you) to 11 (the least
important to you).
2 Provide me with a place to learn and study
___
___ Provide me with opportunities to interact with teachers in and

:
outside of the classroom
___ Allow me to be with my friends
___
4 Prepare me to make a lot of money
___
9 Permit me to continue a particular extra-curricular interest.
(e.g.: sport, fine arts, debating)

15
___ Allow me to better humankind
___ Prepare me for a career
___ Enable me to be more independent
÷
___ Provide me with a variety of new experiences
___ Give me a degree from a prestigious school
___ Other (please specify)
________________________________________________

(Adapted from: Steven R. Antonoff)

Using the lists below, please describe the type of undergraduate environment that you believe will
provide the best fit in terms of your aptitudes, goals, and personal qualities. Feel free to check more
than one choice.
Enrollment: Location:
Very small (fewer than 1500) ✓ Ontario ​ ​ ​
Small (1500-10,000) Another province ​ ​
Medium-sized (10,000-20,000) United Kingdom ​ ​
Large (more than 20,000) ​ United States ​ ​
- No preference Elsewhere (please specify):
​_______________________________
​_______________________________
No preference
Environment: ​
-Large city
Small city or suburban area
Small town or rural area
No preference

List any post-secondary institutions which Please specify

the reasons for these preferences:
are of interest to you at this stage:

McMaster : Health
University
____________________________________ Sci
​ ​___________
_________________________ ​
____________________________________ ​ ​___________
_________________________ ​
____________________________________ ​ ​___________
_________________________ ​
____________________________________ ​ ​___________
_________________________ ​
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________

Are you considering applying to universities outside of Canada?

_______________________________________________________
NO
____________________________
.

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

Have you had an opportunity to write either the ACT or SAT

standardized tests? If so, when?
_______________________________________________________
No
____________________________
.

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________

Are you considering a Gap Year in which you pursue other interests
between high school and post-secondary study?
_______________________________________________________
Maybe
____________________________
.

_______________________________________________________
____________________________

_______________________________________________________
____________________________

_______________________________________________________
____________________________
_______________________________________________________
____________________________

Thank you for taking the time to answer these questions!

3
UCO 2021