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For the students college/guidance counselor to complete

This h s c r is required in order to review the students application. We appreciate your prompt assistance in

completing this form and forwarding the students official transcript.

Please rate this student on the following categories. Attach a separate sheet of paper or use the reverse side of this page to list

additional comments.

How long have you known this student?

In what context do you know this student?

Students class rank Class size

The student s course selection is: Most rigorous Very rigorous Rigorous Average Below average

excellentBelow

average

Dedication to Academic Excellence & Discernment1 2 3 4 5 Not applicable

Commitment to Integrity & Honesty1 2 3 4 5 Not applicable

Responsibility toward Social Justice 1 2 3 4 5 Not applicable

Demonstration of Leadership1 2 3 4 5 Not applicable

Commitment to Diversity1 2 3 4 5 Not applicable

For the student to complete

Please complete the information below, and then give this form to your college/guidance counselor right away. rb,

h s c r q f b .

Name

Mailing Address

High School Name

High School Address

Please list the classes you are taking this year.

numBer and street

city state/province Zip/postal code

country

First name last name

numBer and street

city state/province Zip/postal code country

High School Counselor Report

Please continue

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