Guidance Department – College Recommendation Information
Guidance Office – College Recommendation Information
Please Fill out this form and return it to the Guidance Office by MAY 1st
Student Name
Returned on:
Can this recommendation information be shared with other staff / faculty _____ yes _____ no
FAMILY INFORMATION
Who do you live with?
Name relationship occupation
Name relationship occupation
Number of siblings in your family, including yourself:
How many siblings/ other minors does your family support?
How many siblings / other minors live with you?
How many siblings are in college?
SELF-ASSESSMENT
1. What three words best describe you?
_____________________ _____________________ ______________________
2. What are your personal strengths? Give an example
3. What qualities set you apart from others? Give an example
4. What are your academic strengths? Give an example
5. What has been your favorite class? Why?
6. What are your present career goals (professional or college major)? Why?
7. What has been your most personally rewarding experience at Poly?
8. Of all the activities that you have been involved in during your high school years, which has been most important to you and why?
--Please list any other extracurricular activities/sports (9th through 12th grade):
9. An admissions rep has just opened your file and pulled out your transcript and test scores. What two things would you want to explain? Or what two things would you him/her to know about you? Give examples or relate a specific anecdote to explain
a.
b.
10. Describe any work and/or volunteer experience you have had.
Employment:
Community Service:
11. Describe a book or event that is significant to you.
12. Describe any personal challenge you have faced. How did you respond to it?
13. Admission to college and receiving financial aid often is affected by family circumstances and financial need. I can better advocate if I’m aware of extenuating circumstances that may affect your consideration for admission. Such information will be kept confidential.
14. Comment on anything you feel is pertinent and we haven’t covered.
15. If neither of your parents have earned a Bachelor’s degree (four-year) then you are considered a “first-generation college student” which may be of interest to colleges as they consider students for special programs/scholarships. Please let us know the highest level of education your mother and father have attained. (Please check)
MOTHER__Middle School
__High School
__Some college
__Associate’s Degree (community college)
__Bachelor’s Degree (four-year college)
__Graduate Degree
-----------------------
FATHER__Middle School
__High School
__Some college
__Associate’s Degree (community college)
__ Bachelor’s Degree (four-year college)
__Graduate Degree
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