Full Name
Age
Gender MaleFemaleOther
Contact Number
Email Address
Location / City
Current Class / Year
Stream / Subjects
Academic Performance (Grades / Marks)
Entrance Exams Appeared / Planning
Which career domains interest you most?
Management (MBA)Medicine (MBBS)Engineering / TechnologyLaw / AdvocacyCreative / Media FieldsOther
Why do you feel drawn to this career path?
Top Strength
Which skills do you want to improve?
Short-Term Goal (1–2 Years)
Long-Term Goal (5–10 Years)
Dream Career Role
Lack of clarityExam preparation stressFinancial constraintsFamily expectationsOther
Preferred Mode of Guidance
One-to-One SessionGroup WorkshopOnline CounsellingCareer Assessment Test
How soon would you like to begin counselling?
ImmediatelyWithin 1 monthWithin 6 months
Write one sentence about your dream career and why it matters to you
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