Emory University, Atlanta, Georgia Emory College Secondary School Report/ Counselor Recommendation Student: Please complete the following information and give this form to your secondary school counselor. Applicant's Waiver of Rights of Access to Confidential Statement: I hereby freely and voluntarily waive my rights of access to any information contained in this recommendation form and agree that the statement shall remain confidential. Signature: __________________________________ ------------------------------------------------------------------------------- To facilitate the processing of your application, please submit all your supplementary materials in one package. Student: I am applying for: __ Early Decision I (deadline: Nov. 1) __ Emory Scholars Program (deadline: Nov. 15) (requires separate nomination form; see application instructions for more information) __ Early Decision II (deadline: Jan: 1) ----------------------------------------------- __ Regular Decision (deadline: Jan. 15) ------------------------------------------------------------------------------- Student's Last Name:__________________ First:________________ Middle:___________ Student's Address: _____________________________________________________________ School Name and Address: ______________________________________________________ School telephone number: (____) __________________________________ ACT/CEEB code #:_____________________________________________ Please list below the courses you are taking currently and those in which you will be enrolled during the remainder of this year. Please indicate whether the course is an honors or accelerated selection, and include only academic courses. This chart refers to a trimester system. First Term Second Term Third Term (if applicable) ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___________________________|___________________________|_______________________ ___ Check here if you are taking a block schudule. College Counselor:_______________________________________ This student has submitted an application for admission to Emory University. A full and candid report from the school is necessary in order to give this candidate fair consideration. We ask for your careful evaluation of the student. This report will be used exclusively by the admission committee and does not become part of the student's permanent record. Please file the school report as soon as possible. The Midyear Report should be sent to the Emory University Office of Admission as soon as grades for the first term are available. Admission application deadline for the first-year students entering in the fall is January 15. Note: Please send a current-year transcript that provides the following in order to ensure a correct evaluation of the student's records. __ Indication of honors-, accelerated-, and advanced-placement courses. __ Courses taken, year and grades, including ninth grade. __ Courses failed or repeated __ An explanation of the grading system used __ NMSQT, SAT, ACT scores __ If provided, please indicate how rank in class is determined and indicate, if considered: course grades, school terms and course weighting Candidate Qualifications for Admission to Emory University Below Average Average Above Average Excellent Outstanding Academic Promise __ __ __ __ __ Character & Personality __ __ __ __ __ Overall Recommendation __ __ __ __ __ Report based on __ Personal Contacts __ Counseling Contacts __ Teachers Comments __ Records __ Other In comparison with the academic curricula of other college bound members of the senior class, this student's academic curriculum is: __ less demanding than average __ average college bound program __ more demanding than average __ most demanding How long and in what context have you known the candidate? ____________________ _______________________________________________________________________________ What are the first words that come to mind to describe the applicant? _________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ ------------------------------------------------------------------------------- Counselor's comments and recommendations: On a separate sheet, please feel free to write whatever you think is important about the applicant, including a description of academic and personal characteristics. We are particularly interested in evidence about the candidate's intellectual promise, motivation, maturity, integrity, independence, originality, initiative, leadership potential, capacity for growth, special talents, and enthusiasm. We welcome information that will help us differentiate this student from others. The counselor's recommendation is a required part of the admission application. Name (please print):________________________________________________________ Signature: _________________________________________________________________ Return directly to: Office of Admission Boisfeuillet Jones Center Emory University Atlanta, Georgia 30322-1950 800.727.6036 Emory University does not discriminate in admissions, educational programs, or employment on the basis of or race, color, religion, sex, sexual orientation, national origin, age, disability, or veteran's status and prohibits such discrimination by its students, faculty, and staff. Students, faculty, and staff are assured of participation in university programs and in use of facilities without such discrimination. The university also complies with all applicable federal and Georgia statutes and regulations prohibiting unlawful discrimination. All members of the student body, faculty, and staff are expected to assist in making this policy valid in fact. Any inquiries regarding this policy should be directed to the Emory University Office of Equal Opportunity Programs, Administration Building, Atlanta, Georgia 30322. Telephone 404.727.6016 (V/TTY); fax 404.727.2666.