STUDENT SECTION: CONTACT INFORMATION
FIRST NAME MIDDLE LAST PREFERRED NAME
HOME STREET ADDRESS
CITY STATE ZIP
SCHOOL YOU ATTEND CEEB/ACT CODE
PRIVACY NOTICE: In accordance with the Family Educational Rights and Privacy Act (FERPA), the
original School Report submitted on your behalf reflects your choice to waive or not waive your right
of access to all recommendations and supporting documents. That response applies to all subse-
quent reports, including this one. Chose one of the following:
__ Yes, I do waive my right to access, and I understand I will never see this form or any other
recommendations submitted by me or on my behalf.
__ No, I do not waive my right to access, and I may someday choose to see this form or any
other recommendations or supporting documents submitted by me or on my behalf to Agnes
Scott, if files are saved after I matriculate.
COUNSELOR SECTION
NAME TITLE
DATE
SCHOOL ADDRESS (Street, City, State, ZIP)
OFFICE PHONE EMAIL
Student Information
Question Yes No
Policy prevents
me from stating
Have there been changes to the senior year courses
listed on the original School Report?
Have there been changes in the applicant’s
disciplinary status at your school since you
submitted the original School Report?
To your knowledge, have there been changes to the
applicant’s criminal history since you submitted the
original School Report?
Do you wish to update your original evaluation of
this applicant?
If you responded yes to any of the preceding questions, please attach an explanation.
__ Check if you would prefer to discuss this applicant over the phone with an admission counselor.
If any of the following information has changed for this student since the School Report was
submitted, please enter the updates below.
Class Rank _______ Class Size ______ - covering a period from _______ to ______.
The rank is __ weighted __ unweighted.
(mm/yyyy) (mm/yyyy)
How many additional students share this rank?__________
__ We do not rank. Instead, please indicate quartile ____ quintile ____ decile ______
Cumulative GPA: _____ on a _____ scale, covering a period from _______ to ______.
The rank is __ weighted __ unweighted.
(mm/yyyy) (mm/yyyy)
The school’s passing mark is _________. Highest GPA in class ________________
Graduation Date ________________ (mm/dd/yyyy)
MIDYEAR
REPORT
Students: Complete the
top section, then have your
school counselor or school
ocial complete the rest
of the form. They will then
submit the form to us.
Counselors: Please submit
this form when midyear
grades are available
(end of first semester or
second trimester). Attach
the applicant’s ocial
transcript, including courses
in progress and transcript
legend. (Please check
transcript copies for
readability.) Be sure to
sign this form, then send it
directly to the college:
fax to: 404.471.6414
email to: admission@
agnesscott.edu
mail to: Agnes Scott College
Oce of Admission
141 E. College Ave.
Decatur, GA 30030-3797
For questions, contact
the Oce of Admission at
404.471.6285; toll free at
800.868.8602, ext. 6285 or
admission@agnesscott.edu.
www.agnesscott.edu
SIGNATURE
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