This document is a prospect information form used by the Advanced Technological Education department at a college. It collects contact and background information on a prospect, including their name, address, education history, work experience, and how they were referred. It also records notes from resolving the prospect's information, such as whether an unofficial audit was performed, if the prospect is eligible for the Advanced Technological Education program, and when they were informed of the resolution.

1. Advanced Technological Education
College Park Building, Room 141
Ph: 372-29676
Fax: 372-8667
Contact: Sherri Orwick
Prospect Information Form
(PIF)
Primary Information Last Name: ____________________________
Initial Contact Date: __________ First Name: _________________ M. Initial: _______
Address: ___________________________________________________________________
City: __________________ ST: ______ Zip:_______ E-mail: ______________________
Home Ph: ________________ Work Ph: ________________ Cell Ph: ________________
Associate Degree? Y N Year: ______ Major: ____________________________
Institution: _________________________________ Accredited when attended? Y N
Other Degree: ______________________ Institution:_____________________________
Other Institutions: ___________________________________________________________
Worked full time for 12 consecutive months? Y N Occupation:_____________________
Position/Title: ___________________________ Company: _______________________
Referred by: BGSU Website _______________ College __________________________
Mailing _____________________ Other __________________________
Approx. Date: ________________
Resolution Information
Perform Unofficial Audit? Y N Date: __________________________
Recommended BLS? Y N Reason: ________________________________________
Date to Adult Learning: ___________________________
Recommend Firelands or other College? Y N Reason: __________________________
Eligible for ATE? Y N Reason: ________________________________________
Admission Application Date: ________________ Official Transcripts Requested: Y N
Date prospect was informed: ________________ by: ___________via: ______________

2. Advanced Technological Education Prospect Information Form
College Park Building, Room 141 Page 2 of 2
Ph: 372-29676
Fax: 372-8667
Contact: Sherri Orwick
Notes
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