Delaware County Community College

Last Name

First Name

Male:

Female:

Street

City

State

Zip

Telephone #

Student ID

Email Address

Previous work experience

What would you like to accomplish through career counseling? Check all that apply:

Choose a major

Find direction and focus

Learn how to make appropriate career choices

Learn how to access and use career information (types of jobs, salary, education)

Retrain for a new career

Discuss life issues that influence my career decisions

Other:

Education completed:

List all of the occupations you are considering right now: