Success Connection Application Form

This form is to be completed only by students graduating in January or May of the current academic year. Note - Required fields are indicated by an asterisk (*).

Name Name First Last
Email
Local Phone Local Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Home Phone Home Phone - ### - ### ####
School Address School Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Address Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Expected month and year of graduation:
Major(s)
Cumulative GPA
Activities at Simmons
Essay Questions

Tip: Write/edit your essay in Microsoft Word (or a similar program) and copy/paste in the essay response boxes below.
How does your involvement in the Simmons community or community-at-large shape your goals for the future? (approximately 200-250 words)
What skills or abilities would you like to improve through the Success Connection program as you think about life and career after graduation? (approximately 200-250 words)

Success Connection Application Form

Success Connection Application Form

Essay Questions