UConn Connects - Sign-Up

program participation

I wish to participate in the UConn Connects program. I give permission for my UConn Connects facilitator to access my academic transcript.

basic information

First Name
Last Name
Peoplesoft/EMPL ID
Major/Plan of Study
Semester Standing

participant preferences

Check here if you are new to the UConn Connects program.

Check here if you are a returning UConn Connects participant.

If would like to request a facilitator, please insert the facilitator's name to the right.

permanent address

Street
City
State
Zip
Home Phone

local address

Street/Dorm
City
State
Zip
Local Phone (ie. campus)
Cell Phone

preferred e-mail

questionnaire

This reflection is an important start to the change process that can lead to higher grades, a more accurate sense of self, and greater satisfaction by the end of a the semester. Carefully consider the questions and your answers. Do not answer the questions as you think you SHOULD answer them, but rather, in as straight-forward a way as you can. This information will help you and your facilitator construct an action plan to achieve your goals.

Please note that your responses will only be shared with the UConn Connects staff and your facilitator.

What are the three most important
factors that contributed to your
current academic status?

1)
2)
3)

How important is it you personally
to have a successful semester?

Please rate on a scale of 1-10 with
1 being "not at all important" and
10 being "exceptionally important".

What factors will keep you
from succeeding this semester?

What personal strengths can you draw
on to create a successful semester?

How could your facilitator assist you
in having a successful semester?

How many courses did you take
last semester that incorporated
HuskyCT in some way?

Do you use technology to help you stay organized or aid in your studying?

Student Participant Sign-Up Form

Become a UConn Connects Student!