Fill - Free fillable HOOL REPORT/COUNSELOR RECOMMENDATION SC (Elizabethtown College) PDF form

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HOOL REPORT/COUNSELOR RECOMMENDATION

TO THE APPLICANT

After completing all the relevant questions below, give this form to your secondary school counselor or another school ofﬁcial who knows you better. If applying

via mail, please also give that teacher stamped envelopes addressed to each institution that requires a School Report.

Legal Name ___________________________________________________________________________________________________________________

Last/Family/Sur (Enter name exactly as it appears on official documents.) First/Given Middle (complete) Jr., etc.

Birth Date ___________________________________________________ CAID (Common App ID) _______________________________________________

mm/dd/yyyy

Address ________________________________________________________________________________________________________________________

Number & Street Apartment #

City/Town State/Province Country ZIP/Postal Code

School you now attend CEEB/ACT Code _____________________________________

Current year courses—please indicate title, level (AP, IB, advanced honors, etc.) and credit value of all courses you are taking this year. Indicate quarter

classes taken in the same semester on the appropriate semester line.

Full Year/First Semester/First Trimester Second Semester/Second Trimester Third Trimester

or additional ﬁrst/second term courses if more space is needed

IMPORTANT PRIVACY NOTICE: By signing this form, I authorize every school that I have attended to release all requested records and recommendations to

colleges to which I am applying for admission. I also authorize employees at these colleges to conﬁdentially contact my current and former schools should they

have questions about the information submitted on my behalf.

I waive my right to review all recommendations and supporting documents submitted by me or on my behalf.

I DO NOT waive my right to review all recommendations and supporting documents submitted by me or on my behalf.

• I have chosen not to waive my right to review my recommendations and supporting documents. I understand that my decision may lead my

counselors or teachers to decline to write recommenda

tions on my behalf. I also understand that my decision may lead colleges to disregard

any recommendations submitted on my behalf.

I understand that my waiver or no waiver selection above pertains to all colleges to which I apply and that my selections cannot be changed after any

recommendation or application submission.

Required Signature _____________________________________________________________________________________

Date _________________

TO THE SECONDARY SCHOOL COUNSELOR

Attach applicant’s ofﬁcial transcript, including courses in progress, a school proﬁle, and transcript legend. (Check transcript copies for readability.) Use

both pages to

complete your evaluation for this student. Be sure to sign below before mailing to the Elizabethtown College admission ofﬁce. You

may also fax this form to 717-361-1365 or send via email to apply@etown.edu.

Counselor’s Name (Mr./Mrs./Ms./Dr.)

Please print or type

Signature _________________________________________________________________________________________________ Date _____________________

mm/dd/yyyy

Title School _______________________________________________________

School Address

Number & Street City/Town State/Province Country ZIP/Postal Code

School Website Address _________________________________________________________________________________________________________

Counselor’s Telephone (_______) ________________________________________ Counselor’s Fax (_______) _________________________________________

Area/Country/City Code Number Ext. Area/Country/City Code Number

School CEEB/ACT Code ____________________________ _________________________________________________________________ Counselor’s E-mail

With reservation

The school’s passing mark is

Background Information

Class Rank ___________ Class Size ___________ Covering a period from __________ to __________.

(mm/yyyy) (mm/yyyy)

The rank is p weighted p unweighted. How many additional students share this rank? _________________

How do you report class rank? quartile _____________ quintile _____________ decile ______________

Cumulative GPA: ________ on a _________ scale, covering a period from ____________ to ____________.

(mm/yyyy) (mm/yyyy)

This GPA is p weighted p unweighted. ________________________________.

Highest GPA in class ____________________________________ Graduation Date ___________________

(mm/yyyy)

Percentage of graduating class immediately attending: ___________four-year ________ two-year institutions

Does your school require students to perform volunteer service?

p Yes p No

Is the applicant an Advanced Cambridge (AICE) Diploma Candidate?

p Yes p No

Ratings Compared to other students in his or her class year, how do you rate this student in terms of:

How many courses does your school offer:

AP _________ IB _________ Honors _________

If school policy limits the number a student may take in

a given year, please list the maximum allowed:

AP _________ IB _________ Honors _________

Is the applicant an IB Diploma candidate?

p Yes p No

Are classes taken on a block schedule?

p Yes p No

In comparison with other college preparatory students

at your school, the applicant’s course selection is:

p less than demanding

average demanding

very demanding

most demanding

prefer not to respond

One of the top

Very good few I’ve

Below Good (above (well above Excellent Outstanding encountered

No basis average Average average) average) (top 10%) (top 5%) (top 1%)

Academic achievement

Extracurricular accomplishments

Personal qualities and character

OVERALL

Has the applicant ever been found responsible for a disciplinary violation at your school from the 9

grade (or the international equivalent) forward, whether related

to academic misconduct or behavioral misconduct, that resulted in a disciplinary action? These actions could include, but are not limited to: probation, suspension,

removal, dismissal, or expulsion from your institution.

p Yes p No p School policy prevents me from responding

To your knowledge, has the applicant ever been adjudicated guilty or convicted of a misdemeanor or felony?

p Yes p No p School policy prevents me from responding.

[Note that you are not required to answer “yes” to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed,

annulled, pardoned, destroyed, erased, impounded, or otherwise ordered to be kept conﬁdential by a court.]

If you answered “yes” to either or both questions, please attach a separate sheet of paper or use your written recommendation to give the approximate date of each

incident and explain the circumstances.

Applicants are expected to immediately notify the institutions to which they are applying should there be any changes to the information requested in this application,

including disciplinary history.

p Check here if you would prefer to discuss this applicant over the phone with each admission office.

I recommend this student:

p No basis p p Fairly strongly p Strongly p Enthusiastically

Evaluation

lease write whatever you think is important about this student, including a description of academic and personal characteristics, as

demonstrated in your classroom. We welcome information that will help us to differentiate this student from others. Please feel free

to attach an additional sheet or another reference you may have prepared on behalf of this student.

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