Secondary School Report Example Form

Secondary School Report Form National Association for College Admission Counseling Instructions Students should complete Section I and submit the form to their school counselor. Counselors should complete Sections II and III and forward the report form along with other supporting documents to each school to which the student is applying. SECTION I to be completed by student Student Name SSN Address Date of Birth mm/dd/year City State/Province ZIP/Postal Code Country Phone Email Address I am applying for Early Decision Early Action Regular Decision Other IMPORTANT PRIVACY NOTE By signing this form I authorize all schools I have attended to release all requested records covered under the Federal Educational Rights and Privacy Act FERPA so that my application may be reviewed by the institution s to which I am applying. I further authorize the admission officers reviewing my application including seasonal staff employed for the sole purpose of evaluating applications to contact officials at my current and former schools should they have questions about the school forms submitted on my behalf* es 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 Y o I do not waive my right to access and I may someday choose to see this form or any other recommendations or supporting N documents submitted by me or on my behalf to the institution at which I m enrolling if that institution saves them after I matriculate. Required Signature Date High School Fax Counselor s Name Title Percentage of class attending Grading Scale Four-Year GPA includes check all that apply Student rank Two-Year Student s GPA Passing Grade 9th Grade Most Demanding Very Demanding SENIOR-YEAR COURSES First Term Course Weighted Unweighted as of 9th Grade in a class of This student s course selection is institutions. Grade Second Term Page 1 of 2 Average We do not rank. Below Average Please comment on the following items which reference the student s ability and character. Attach additional pages if more space is needed* A recommendation letter may replace Section III. Academic Ability Personal Character Is the academic record of this student an accurate indication of the student s ability If not please describe the circumstances Yes No Counselor Statement Thank you. Counselors should complete Sections II and III and forward the report form along with other supporting documents to each school to which the student is applying. SECTION I to be completed by student Student Name SSN Address Date of Birth mm/dd/year City State/Province ZIP/Postal Code Country Phone Email Address I am applying for Early Decision Early Action Regular Decision Other IMPORTANT PRIVACY NOTE By signing this form I authorize all schools I have attended to release all requested records covered under the Federal Educational Rights and Privacy Act FERPA so that my application may be reviewed by the institution s to which I am applying. SECTION I to be completed by student Student Name SSN Address Date of Birth mm/dd/year City State/Province ZIP/Postal Code Country Phone Email Address I am applying for Early Decision Early Action Regular Decision Other IMPORTANT PRIVACY NOTE By signing this form I authorize all schools I have attended to release all requested records covered under the Federal Educational Rights and Privacy Act FERPA so that my application may be reviewed by the institution s to which I am applying. I further authorize the admission officers reviewing my application including seasonal staff employed for the sole purpose of evaluating applications to contact officials at my current and former schools should they have questions about the school forms submitted on my behalf* es 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 Y o I do not waive my right to access and I may someday choose to see this form or any other recommendations or supporting N documents submitted by me or on my behalf to the institution at which I m enrolling if that institution saves them after I matriculate.