2012 11CAO Highlighted 1

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011-12 First-year ApplicationFor Spring 2012 or Fall 2012 Enrollment

AP-1/201 2011 The Common Application, Inc.

APPLICANT

Legal Name ________________________________________________________________________________________________________________Last/Family/Sur (Enter nameexactlyas it appears on official documents.) First/Given Middle (complete) Jr., etc.

Preferred name, if not first name (only one)____________________________ Former last name(s) __________________________________________

Birth Date _____________________________________ US Social Security Number, if any ________________________________

mm/dd/yyyy Required for US Citizens and Permanent Residents applying for financial aid via FA

Preferred Telephone Home Cell Home (_______) __________________________________ Cell (_______) ______ ________________Area/Country/City Code Area/Country/City Code

E-mail Address ________________________________________________ IM Address __________________ __________

Permanent home address ___________________________________________________________________ ________Number & Street Apartment #

_________________________________________________________________________________ ___________City/Town County or Parish State/Province Country ZIP/Postal C

If different from above, please give your current mailing address for all admission corresponden _____ to _________(mm/dd/yyyy) (mm/dd/yyyy

Current mailing address _____________________________________________________ _____________________Number & Street Apartment #

__________________________________________________________________ __________________________City/Town County or Parish State/Province Country ZIP/Postal C

If your current mailing address is a boarding school, include name of school here: _________________________________

FUTURE PLANS

Your answers to these questions will vary for different colleges. If the on me of the questions you see in this section, this collechose not to ask that question of its applicants.

College __________________________________________ _______________________________________________mm/dd/yyyy

Entry Term: Fall (Jul-Dec) pring (Jan-Ju

Decision Plan____________________________

Academic Interests ___________________

_______________________________

___________________________ ___

Career Interest_____________ _______

end to apply for need-based financial aid? Yes N

u intend to apply for merit-based scholarships? Yes N

o you intend to be a full-time student? Yes N

Do you intend to enroll in a degree program your first year? Yes N

Do you intend to live in college housing? ___________________________

hat is the highest degree you intend to earn? _______________________

DEMOGRAPHICS

Female Male

Citizenship Status _________________

Non-US Citizen _____________________

_____________ ________________________

________________ ____________________________

Birthplace ____________ _________________________________City/Town State/Province Country

Years lived in the US? ____________

S(Speak) R(Read) W(Write) F(First Language) H(Spoken at Home)

Optional The items with a gray background are optional. No information youThe items with a gray background are optional. No information youprovide will be used in a discriminatory manner.provide will be used in a discriminatory manner.

Religious PreferenceReligious Preference ______________________________________________________________________________________________

1.1. Are you Hispanic/Latino?Are you Hispanic/Latino?

Yes, Hispanic or Latino (including Spain)Yes, Hispanic or Latino (including Spain) NoNo If yes, please describe your backgrouIf yes, please describe your backgrou

____________________________________________________________________________________________________________________

2.2. Regardless of your answer to the prior question,Regardless of your answer to the prior question, please indicate how you identplease indicate how you identourself. ( and describe your background.)ourself. ( and describe your background.)

American Indian or Alaska NaAmerican Indian or Alaska Native (including all Original Peoples of the Americas)tive (including all Original Peoples of the Americas)

Are you Enrolled?Are you Enrolled? YesYes No If yes, please enter Tribal Enrollment Number_____________No If yes, please enter Tribal Enrollment Number_____________

____________________________________________________________________________________________________________________

Asian (including Indian subcontinent and Philippines)Asian (including Indian subcontinent and Philippines)

____________________________________________________________________________________________________________________

Black or African American (including Africa and Caribbean)Black or African American (including Africa and Caribbean)

____________________________________________________________________________________________________________________

Native Hawaiian or Other Pacific Islander (Original Peoples)Native Hawaiian or Other Pacific Islander (Original Peoples)

____________________________________________________________________________________________________________________

White (including Middle Eastern)White (including Middle Eastern)

____________________________________________________________________________________________________________________

__________ode

________________________ __

_____________________________ ____ _ Apartment #ent #

_________________________________ __ ___tate/Provinceovince CountryCo

e. (from _____e. _mm

_______________________________ ___Ap

_____________________________ ___ __ __tate/Province

_____________________________ ___ ____ ___

URE PLANSPP

ne system did not ask you to answer st a er s

_________________ __ Deadline ___lin

))

_________________________ ___

____________________________ ___

__________________________________ ___ __

_______________________________ __ ___ ___

______________________________ __ _

Do you iu i

Do y

______________________________ __ ___

ipip ___________________________ ___

_________________________ ___

____________________

____________

equired for US Cit izens and Permanent Residen a plying for f inancial aid via FA

Years lived outside the US? ____________

Language Proficiency (Check all that apply.)(Speak) R(Read) W(Write) F(First Language) H(Spoken at Home)

S R F H

_______________________________________________

_______________________________________________

_______________________________________________

Check one or moreCheck one or more

US Armed SerUS Armed Services veteran statusvices veteran status __________________________________________________________________________


2/13AP-2/2011 2011 The Common Application, Inc.

FAMILY

Please list both parents below, even if one or more is deceased or no longer has legal responsibilities toward you. Many colleges collect this information for demographpurposes even if you are an adult or an emancipated minor. If you are a minor with a legal guardian (an individual or government entity), then please list that informatiobelow as well. If you wish, you may list step-parents and/or other adults with whom you reside, or who otherwise care for you, in the Additional Information section.

HouseholdParents marital status (relative to each other): Never Married Married Widowed Separated Divorced (date _______

mm/yyyWith whom do you make your permanent home? Parent 1 Parent 2 Both Legal Guardian Ward of the Court/State Other

Legal Guardian (if other than a parent)

Relationship to you _______________________

_________________________________Last/Family/ Sur First/Given Middle Title (Mr./Mrs./Ms./Dr.)

Country of birth ________________ ___

Home address if different from yo

_____________________ __________

_________________ ______________

Preferred Telephon ________________Area/Country/City Code

E-mail ______ _______________________

Occupation _______ ____________________________

Employer _____________ ________________________________

College (if any) ___________________________________ CEEB ________

Degree _________________________________________ Year _________

Graduate School (if any) ____________________________ CEEB________

Degree _________________________________________ Year _________

Siblingsse give names and ages of your brothers or sisters. If they are enrolled in

rades K-12 (or international equivalent), list their grade levels. If they have

attended or are currently attending college, give the names of the undergraduainstitution, degree earned, and approximate dates of attendance. If more thanthree siblings, please list them in the Additional Information section.

__________________________________________________________Name Age & Grade Relationship

College Attended ___________________________________ CEEB ____

Degree earned _________________________ Dates _______________r expected mm/yyyy mm/yyyy







Parent 1: Mother Father Unknown

Is Parent 1 living? Yes No (Date Deceased ____________________)

mm/yyyy

____________________________________________________________Last/Family/ Sur First/Given Middle Title (Mr./Mrs./Ms./Dr.)

Country of birth ________________________________________________

Home address if different from yours

____________________________________________________________

____________________________________________________________

Preferred Telephone: Home Cell Work (_______) ________________Area/Country/City Code

E-mail _______________________________________________________

Occupation _____________________________________________________

Employer _____________________________________________________

College (if any) ___________________________________ CEEB______

Degree _________________________________________ Ye r ___

Graduate School (if any) ____________________________ CE

Degree _______________________________________

Parent 2: Mother Father Unknown

Is Parent 2 living? Yes No (Date Deceased __________________

mm/yyyy

Last/Family /Sur First/Given Middle Title (Mr./Mrs./Ms.

Country of birth ________________ ____________

Home address if different from yo

_____________________ ________

_________________ ____________

Preferred Telephon ______________Area/Country/City Code

E-mail ___ ____________________

Occup _________________________

_____________________________

_______________________ CEEB_____

___________________________ Year ______

y) ____________________________ CEEB_____

____________________________________ Year ______

Spouse/Child

mm/yyyy mm/y

_

______

___________

__ YeYe r __________

MiddM

_________________ __

rsrs

______________________________ ____ __

_________________________________ __ ___

:: Home CellCell Work (______rkArea/CoA

______________________________ __ __

tion ___________________________ ___

mployer _____________________plo ___ ___

College (if any)if a _________________

DegreeDe ________________

Graduate School (if aad

Degreeee ____

___________________________ ___

________________________________ _Middle Title (Mr./Mrs./Ms./Dr.)Ti tl . /Dr. )

_______________________________ __ ___ ___

rsrs

_______________________________ ________________

__________________________________ ___

:: Home CellCe Work (______rk (_Area/CoArea

___________________________ ___

____________________

__________

iblinPle

Civil Union/Domestic Partners

Spouse/ChildSpouse/Child College Attended __________________________________ CEEB______

Marital Status _____________________ Degree Earned/Expected _______________________ Dates ___________mm/yyyy mm/y

pouses Name __________________________________________________ If you have children, how many? _________



EDUCATIONSecondary SchoolsMost recent secondary school attended ___________________________________________________________________________________________

Entry Date _________________ Graduation Date _________________ School Type: Public Charter Independent Religious Home Schmm/yyyy mm/dd/yyyy

Address ________________________________________________________________________________ CEEB/ACT Code ________________________Number & Street

_______________________________________________________________________________________________________________________________City/Town State/Province Country ZIP/Postal C

Counselors Name __________________________________________________________Counselors Title ____________________________________

E-mail _____________________________________ Telephone (_______) ______________________ Fax (_______) _____ __________________ Area/Country/Ci ty Code Number Ext. Area/Count ry/City Code Number

List all other secondary schools you have attended since 9th grade, including summer schools or enrichment programs hosted ool campus:

School Name & CEEB/ACT Code Location (City, State/Province, ZIP/Postal Code, Country) Dates Attended (mm/yy

_____________________________________________ _______________________________________ _______

_____________________________________________ ___________________________________ _________

_____________________________________________ ________________________________ ____________

Please list any community program/organization that has provided free assistance with your application pr ________________

If your education was or will be interrupted, please indicate so here and provide details in the Additio ____________________

Colleges & Universities

College/University Name & CEEB/ACT Code Location (City, State/Province, ZIP/Postal Code, Country) Degree Candidate? CO EP Dates Attended Degree Ea

Yes No mm/yyyy mm/yyyy

_________________________________ ________________________ ______________ _______

_________________________________ _____________________ ______________ _______

_________________________________ __________________ ______________ _______

ACADEMICS

The self-reported information in this section is not intend rds. Please note the requirements of each institution to which you arpplying and arrange for official transcripts and score school and the appropriate testing agencies. Where Best Scores are

requested, please report the highest individual scor scores are from different test dates.

Grades Class Rank _________ Class Si No GPA _________ Scale _________ Weighted? Yes if available) if available)

ACT Exam Dates: ________ Scores: _________ ______ _________ ______ _________ ____past & future) mm/yyyy far) OMP mm/yyyy nglish m/yyyy Math mm/y

_________ ______ _________ ______ _________ ____Reading mm/yyyy cience m/yyyy riting mm/y

SAT Exam Dates: __ Best Scores: _________ ______ _________ ______ _________ ____past & future) so far) ritical Reading mm/yyyy Math mm/yyyy Writing mm/y

TOEFL/ Exam Date _ Best Score: _________ ______ ______IELTS past & future so far) Test core mm/yyyy

AP/IB/SATSubjects

Best ______________________ _____ ________ __________________________________ __per Type & Subject core mm/yyyy Type & Subject c

__________________________ _____ ________ __________________________________ ___Type & Subject core mm/yyyy Type & Subject c

______________________________ _____ ________ __________________________________ ___Type & Subject core mm/yyyy Type & Subject c

__ __________________________________ _____ ________ __________________________________ ___m Type & Subject core mm/yyyy Type & Subject c

Current Courses Please indi te title, level (AP, IB, advanced honors, etc.) and credit value of all courses you are taking this year. Indicate quarter classes taken the same semester on the appropriate semester line.

Full Year/First Semester/First Trimester Second Semester/Trimester Third Trimesteror additional first/second term courses if more space is need

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

________________________________________ ________________________________________ ______________________________________

_______ode

n a secondary scar

untry)untruntr Dates ADD

__________________ ____ ___________

_____________________ _____________

___________________________ __ ____

cess:ces ____________________________ __

l Information section:l In ______________

ountry)oo Degree Candidate?egregr

Yes No

____________________ ____

_______________________ ___

___________________________ __

ACADEEEMICS

d to take the place of your official recd to receports to be sent from your secondaryepo fro

s you have earned so far, even if thoss yo ed s

e _________ Weighted?___ We Yess

_______ ___________ _ _ BesBesmm/yyyym m/yyyy s s

_____ ________ __________ __ ________m/yyyy mm/yyyy yyy m/yyyyy

: ________ ________ ____________ ___)) m/yyyy/yyyy mm/yyyym/yyy mm/yyyy

cores:cor __________ _______________subject, so far)subjec mm/yyyyy

___________ ________mm/yyyymm/yy

__________ ___mm/yyyy

_________ /yyyy/yyyy

Colleges & UniversitiesColleges & Universities Report all college attendance (including online) since 9th grade and ment Program (EP) hosted on ndicate as College Course (CO) or Enrindic e C

ollege campus.PPOOOO

Were you issued a transcript for any work listed above? Yes No t sent as soon as possible.If yes, please have an official transcrie a ri


4/13



Common Application member institution admission offices do not discriminate on the basis of race, color, ethnicity, national origin, religion, creed, seCommon Application member institution admission offices do not discriminate on the basis of race, color, ethnicity, national origin, religion, creed, sege, marital status, parental status, physical d isability, learning disability, political affiliation, veteran status, or sexual orientation.ge, marital status, parental status, physical d isability, learning disability, political affiliation, veteran status, or sexual orientation.

WRITING

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

___________________________________________________________________________________________________ ____________________

______________________________________________________________________________________________ _______________

Please write an essay of on a topic of your choice or on one of the options listed below, and attach it to mission. Plea

indicate your topic by checking the appropriate box. his personal essay helps us become acquainted with you a courses,

rades, test scores, and other objective data. It will also demonstrate your ability to organize your thoughts and ex plication

essay should be the same for all colleges. Do not customize it in any way for individual colleges. Colleges that ask for them

supplement form.

Evaluate a significant experience, achievement, risk you have taken, or ethical dilemma you

Discuss some issue of personal, local, national, or international concern and its importan

Indicate a person who has had a significant influence on you, and describe that influe

Describe a character in fiction, a historical figure, or a creative work (as in art, musi e on you, and explain that influen

A range of academic interests, personal perspectives, and life experiences ad our personal background, describexperience that illustrates what you would bring to the diversity in a college trated the importance of diversity to you

Topic of your choice.

Additional Information Please attach a separate sheet if you wish to pr ations not reflected in the application.

Disciplinary History Have you ever been found responsible for a disciplinary violatio attended from the 9th grade (or the international equivale

forward, whether related to academic misconduct or behavio linary action?robation, suspension, removal, dismissal, or expulsio

Have you ever been adjudicated guilty or convicted of Yes No[Note that you are not required to answer yes to , if the criminal adjudication or conviction has been expunged, sealed,nnulled, pardoned, destroyed, erased, impoun e kept confidential.]

If you answered yes to either or both questions that gives the approximate date of each incident, explains the circumstances, a

reflects on what you learned from the experie

SIGNATURE

Application Fee Payment lication fee, how will you be paying it?lication fee, how will you be paying it?

Online PaymOnline Paym ee Waiver Requestee Waiver Request Will Mail Fee Waiver RequestWill Mail Fee Waiver Request

Required Signature

I certify that a the admission processincluding the application, the personal essay, any supplements, and any other supportingI certify that a the admission processincluding the application, the personal essay, any supplements, and any other supportingmaterialsis m true, and honestly presented, and that these documents will become the property of the institutions to which I am applyingmaterialsis m true, and honestly presented, and that these documents will become the property of the institutions to which I am applying

and will not be retu derstand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, orand will not be retu derstand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, orrevocation of course cr des, and degree, should the information I have certified be false.revocation of course cr des, and degree, should the information I have certified be false.

I acknowledge that I have reviewed the application instructions for each college receiving this application. I understand that all offers of admission are conditionaI acknowledge that I have reviewed the application instructions for each college receiving this application. I understand that all offers of admission are conditionapending receipt of final transcripts showing work comparable in quality to that upon which the offer was based, as well as honorable dismissal from the school.pending receipt of final transcripts showing work comparable in quality to that upon which the offer was based, as well as honorable dismissal from the school.

I affirm that I will send an enrollment deposit (or equivalent) to only one institution; sending multiple deposits (or equivalent) may result in the withdrawal of myI affirm that I will send an enrollment deposit (or equivalent) to only one institution; sending multiple deposits (or equivalent) may result in the withdrawal of myadmission offers from all institutions. [Note: students may send an enrollment deposit (or equivalent) to a second institution where they have been admitted fromadmission offers from all institutions. [Note: students may send an enrollment deposit (or equivalent) to a second institution where they have been admitted fromthe waitlist, provided that they inform the first institution that they will no longer be enrolling.]the waitlist, provided that they inform the first institution that they will no longer be enrolling.]

ignature _______________________________________________________________________________________________ Date __________________ignature _______________________________________________________________________________________________ Date __________________mm/dd/yyyy

_

_____________

your application before suyour ef

a person and student, apart frors nd s ap

ress yourself.se NOTE: Your Common A: Yo o

ant customized essay responses willa d nses w

ave faced and its impact on you.ave mpa yo

e to you.e to

ce.ce.

, science, etc.) that has had an influenence, at

s much to the educational mix. Givens he educ venommunity or an encounter that demonun cou on

ide details of circumstances or qualifiils nce

at any educational institution you havat an stital misconduct, that resulted in a disciduct, ed

from the institution.fro . Yes No

misdemeanor, felony, or other crimemi crimeis question, or provide an explanatiois ro

ed, or otherwise ordered by a court toed, o ord

, please attach a separate sheet of papeatta ep

ce..

ymentymentyment If this college requires an apIf this college requires an aplleglleg

ntntntnt Will Mail PaymentWill Mail Paymentil Pil P OnlineOnline

gngngn

l information submitted inl information submitted inl inf mat l inf mat own work, factuallown work, factuallowow

ed to me. I ued to me. I uededdit, grdit, grdit,dit,

Please briefly elaborate on one of your extracurricular activities or work experiences in the space below.

250 500 words

Additional InformationAdditional Information

These actions could include, but are not limiteto:

Note: Applicants are expected to im ich they are applying should there be any changes to he information requestediately notify the institutions to wedia no st o w in this application, including disci linary history.lin y.


6/13 2011 The Common Application, Inc. TE-1/201

TO THE APPLICANT

After completing all the relevant questions below, give this form to a teacher who has taught you an academic subject (for example, English, foreign language, ma

science, or social studies). If applying via mail, please also give that teacher stamped envelopes addressed to each institution that requires a Teacher Evaluation.

Legal Name __________________________________________________________________________________________________________Last/Family/Sur (Enter nameexactlyas it appears on official documents.) First/Given Middle (complete) Jr., etc.

Birth Date ___________________________________________________mm/dd/yyyy

Address ____________________________________________________________________________________ _________Number & Street Apartment # City/Town State/Province Country ZIP/Postal Code

chool you now attend ________________________________________________________ CEEB/ACT C _________

TEACHER EVALUATION 1

TO THE TEACHER

The Common Application membership finds candid evaluation y qualified candidates. You are encouraged to keep this formin your private files for use should the student need additio our references promptly, and remember to sign below beformailing directly to the college/university admission

Teachers Name (Mr./Mrs./Ms./Dr.) ___________ ______ Subject Taught ____________________________________Please print or type

ignature _________________________ __________________________________________ Date __________________mm/dd/yyyy

econdary School ___________ ____________________________________________________________________

chool Address _______ __________________________________________________________________________Number & Street City/Town State/Province Country ZIP/Postal Code

Teachers Telepho ________________________________Teachers E-mail __________________________________Area/Country/City Code Number Ext.

Background Information

How long have you known nd in what context? ____________________________________________________________________________

What are the first words that co e to your mind to describe this student? __________________________________________________________________

List the courses in which you have taught this student, including the level of course difficulty (AP, IB, accelerated, honors, elective; 100-level, 200-level; etc.).

____________________________________________________________________________________________________________________________

2011-12 Teacher EvaluationFor Spring 2012 or Fall 2012 Enrollment

Fem Ma

T

IMPORTANT PRIIMPORTANT PRIVVACY NOTICE:ACY NOTICE: Under the terms of the Family Educational Rights and Privacy Act (FEUnder the terms of the Family Educational Rights and Privacy Act (FE access to this formaccess to this formnd all other recommendations and supporting documents submitted by you and on your behalf, u :nd all other recommendations and supporting documents submitted by you and on your behalf, u :

1. The institution does not save recommendations post-matriculation1. The institution does not save recommendations post-matriculation (see list at www.common(see list at www.common2. You waive your right to access below, regardless of the institution to which it is sent:2. You waive your right to access below, regardless of the institution to which it is sent:

Yes, I do waive my right to access, and I understand I will never see this form or any e or on my behalf. Yes, I do waive my right to access, and I understand I will never see this form or any e or on my behalf.No, I doNo, I do not waivenot waivemy right to access, and I may someday choose to see this form rting documents submitted by memy right to access, and I may someday choose to see this form rting documents submitted by me

or on my behalf to the institution aor on my behalf to the institution at which I'm enrolling, if that institution savest which I'm enrolling, if that institution saves

Required SignatureRequired Signature ______________________________________________________________________________________ ______________ Date _______________________________ Date _________________

___________________________ __ZIP/Postal Co/Po

de __________________________ ______

A), after you matriculate youA), after you matriculate youA), tricu ou A), tricu ouwillwillhavhavess at least one of the following is truess at least one of the following is truess llo g iess llo g i

pp.org/FERPA).pp.org/FERPA).pp. pp.

her recommendations submitted byher recommendations submitted byom atioom atior any other recommendations or suppr any other recommendations or suppr a ecomm uppr a ecomm upp

OOO THE TEACHER

helpful in choosing from among high hoos mal recommendations. Please submital r Plea ub

ffice.ffic

_______________________________ ___Please print or typent or

___________________________________ ____ ___

_______________________________ __ __

_______________________________ ___Number & StreetNum eet

e (_______) _________________e ( __ ___Area/Country/City Code/City

ationatioatio

this studentthis

em after I matriculate.em after I matriculate.afte late.afte late.

_____________________________________________________________ ___ _________ ___ ______

ommon Application offices.Do not mail this form to TheThe

In which grade level(s) was the student enrolled when you taught him/her? 9 10 11 12 Other__________________________________

CAID ________________________________ _________________________


7/13


8/13


9/13 2011 The Common Application, Inc. TE-2/ 011-

Ratings Compared to other students in his or her class year, how do you rate this student in terms of:

No basis

Below

average Average

Good (above

average)

Very good

(well above

average)

Excellent

(top 10%)

Outstanding

(top 5%)

One of the t

few Ive enco

tered

(top 1%)

Intellectual promise

Quality of writingQuality of writing

Creative, original thoughtProductive class discussionProductive class discussion

Respect accorded by faculty

Disciplined work habitsDisciplined work habits

Maturity

MotivationMotivation

Leadership

IntegrityIntegrity

Reaction to setbacks

Concern for othersConcern for others

Self-confidence

Initiative, independenceInitiative, independence

OVERALL

Evaluation Please write whatever you think is important about this student, personal characteristics, as demonstrated inyour classroom. We welcome information that will help us to differentiate th ch an additional sheet or another reference you mhave prepared on behalf of this student.)

TEACHER EVALUATION 2

cluding a description of academic aning tion ic anstudent from others. (Feel free to attfro eel


10/13


11/13 2011 The Common Application, Inc. SR-2/2011

Evaluation Please provide comments that will help eel free to attach an additional sheet or another reference you have prepared fthis student. We especially welcome a broad-based assessment

nd encourage you to consider describing or ad

or other circumstances, either posi

Ratings Compared to other students in his or her class year, how do you rate this stude

Has the applicant eve onsible for a disciplinary violation at your school from the 9th grade (or the international equivalent) forward, whether relat

o academic misconduc ral misconduct, that resulted in a disciplinary action? probation, suspensioremoval, dismissal, or expu rom your institution.Yes No

o your knowled e, has the applicant ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime?Yes NoNote that you are not required to answer yes to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed,nnulled, pardoned, destroyed, erased, impounded, or otherwise ordered to be kept confidential by a court.]

If you answered yes to either or both questions, please attach a separate sheet of paper or use your written recommendation to give the approximate date of eachincident and explain the circumstances.

Check here if you would prefer to discuss this applicant over the phone with each admission office.

I recommend this student:I recommend this student: No basisNo basis With reservationWith reservation Fairly stronglyFairly strongly StronglyStrongly EnthusiasticallyEnthusiastically

Background Information

No basis

Below

average Average

Good (above

average)

Very good

(well above

average)

Excellent

(top 10%)

Outstanding

(top 5%)

One of the t

few Ive enco

tered

(top 1%)

Extracurricular accomplishmentsExtracurricular accomplishments

Personal qualities and character

OVOVERALLERALL

Ho long have you known this student and in what context? ___________________________________ ______________

What are the first words that come to your mind to describe this student? ___________________ ___________________

How many courses does your school offer:How many courses does your school offer:AP _________ IB _________ Honors _______AP _________ IB _________ Honors _______

Is the applicant an IB Diploma candidate?Is the applicant an IB Diploma candidate? YesYes

Are classes taken on a block schedule?Are classes taken on a block schedule? YesYes

In comparison with er college preparatory studeIn comparison with er college preparatory studet your school, t nts course selection is:t your school, t nts course selection is:

most demost de very dvery d dede

Class Rank ___________ Class Size ___________ Covering a period from __________ to __________.Class Rank ___________ Class Size ___________ Covering a period from __________ to __________.(mm/yyyy) (mm/yyyy)

The rank isThe rank is weightedweighted unweighted. How many students share this rank? _________________unweighted. How many students share this rank? _________________

How do you report class rank? quartile _____________ quintile _____________ decile ______________How do you report class rank? quartile _____________ quintile _____________ decile ______________

Cumulative GPA: ________ on a _________ scale, covering a period from ____________ to ____________Cumulative GPA: ________ on a _________ scale, covering a period from ____________ to ____________

(mm/yyyy) (mm/yyyy)

This GPA isThis GPA is weightedweighted unweighted. The schools passing mark is ________________________________.unweighted. The schools passing mark is ________________________________.

Highest GPA in class ____________________________________ Graduation Date ___________________Highest GPA in class ____________________________________ Graduation Date ___________________(mm/dd/yyyy)

Percentage of graduating class immediately attending: ___________four-year ________ two-year institutionsPercentage of graduating class immediately attending: ___________four-year ________ two-year institutions

s differentiate this student from others.s di s st

ressing:

ve or negave tive.

in terms of:of:

been found resbee

or behavior bionion

verage

Good (aboveaboabo

average)

VVVery gooderyery

well abovel abovel above

averag

_______________________________ ____ __

_______________________________ _____

tttte applice applicpplppl

andingandingmandingmanding

andingandingandingandingverageveragegege

below averagebelow averageveve

additionaladditional If school policy limits the number a student may takeIf school policy limits the number a student may takegiven year, please list the maximum allowed:given year, please list the maximum allowed:

AP _________ IB _________ Honors _______AP _________ IB _________ Honors _______

Alternatively, you may attach a referen an better describe the student.e written by another school official whoten b er s

These actions could include, but are not limited to: School policy prevents me from responding

School policy prevents me from responding.

Applicants are expected to immediately notify the institutions to which they are applying should there be any changes to the information requested in this applicatioincluding disciplinary history.


12/13 2011 The Common Application, Inc. MR-1/201

011-12For Spring 2012 or Fall 2012 Enrollment

TO THE APPLICANT

After completing the information in this section, give this form to your school counselor or another school official who knows you better. If applying via mail,

please also give that school official stamped envelopes addressed to each institution to which you have applied.



Address ________________________________________________________________________________________ _____________Number & Street Apartment # City/Town State/Province Country ZIP/Postal C

chool you now attend ________________________________________________________ CEEB/ACT Code ________

Counselors Name (Mr./Mrs./Ms./Dr.) _____________________ ___________________________________________Please print or type

ignature _______________________________________ ____________________________ Date __________________mm/dd/yyyy

Title ____________________________________ _____________________________________ ______________

chool Address _______________________ _________________________________________________________

Number & Street City/Town State/Province Country ZIP/Postal Code

chool Website Address ___________ ______________________________________________________________

Counselor Telephone (_______) ___________ Counselors Fax (_______) ______________________________________ Area/Country/City Code Number Ext. Area/Country/City Code Number

chool CEEB/ACT Code __ ____ Counselors E-mail ______________________________________________________

TO THE SCHOOL COUNSELOR

Please submit this form when midyear grades are available (end of first seme nts official transcript, including coursesin progress and transcript legend. (Please check transcript copies for reada ailing directly to the college/universitydmission office. Do not mail this form to The Common Application

Fem Ma

M

Background Information ow has changed for this student since the School Report was submitted, please enter the new informatiothe appropriate

CClass Rank _______ g a period from _______ to ______.lass Rank _______ g a period from _______ to ______.(mm/yyyy) (mm/yyyy)

The rank isThe rank is weightedweightedHow many additional students rank?__________How many additional students rank?__________

We do not rank. Instead, please indicate quartile ____ quintile ____ decile ______We do not rank. Instead, please indicate quartile ____ quintile ____ decile ______

Cumulative GPA: _____ on a _____ scale, covering a period from _______ to ____Cumulative GPA: _____ on a _____ scale, covering a period from _______ to ____(mm/yyyy) (mm/y

This GPA isThis GPA is weightedweighted unweighted. The schools passing mark is ___________unweighted. The schools passing mark is ___________Highest GPA in class _____________________ Graduation Date _____________Highest GPA in class _____________________ Graduation Date _____________

(mm/dd/yyyy)

If you responded yes to any of the preceding questions, please attach an explanation.

Check here if you would prefer to discuss this applicant over the phone with each admission office.

________________Countryuntr

___________________________ ____ __

__________________________________ __lease print or typeint or ty

________________________________ _____ __

__________________________ __ Schoo

_______________________________ ___

City/Toity/T n

_____________________________________ ___ __

_______________________________ _ ___y/City Codey/Ci umber

_______________________________ __ ___

L COUNSELOOOR

er or second trimester). Attach applicsec ster . plicility.) Be sure to sign below beforeur lo

offices.

rmationrmrm If any of the information bean nforection below.ecti

Class Size ______ CoveriClass Size ______ CoveriCla izeCla ize

unweighted.unweighted.ununshare thishare thisharshar

MIDYEAR Report

IMPORTANT PRIIMPORTANT PRIVVACY NOTE:ACY NOTE: In accordance with the Family Educational Rights and Privacy Act (FERPA), th ur behalfIn accordance with the Family Educational Rights and Privacy Act (FERPA), th ur behalforiginal School Report submitted on yoriginal School Report submitted on yrigin epo on yrigin epo on yreflects your choice to waive or not waive your right of access to all recommendations and supporting d ubsequent reportreflects your choice to waive or not waive your right of access to all recommendations and supporting d ubsequent reportcuments. That response applies to allcuments. That response applies to allc That e ac That e aincluding this one. You chose the following:including this one. You chose the following: Yes, I do waive my right to access, and I understand I will never see this form or any other reco y behalf. Yes, I do waive my right to access, and I understand I will never see this form or any other reco y behalf.mendations submitted by me or onmendations submitted by me or onm me r om me r o No, I do not waive my right to access, and I may someday choose to see this form or any ot uments submitted by me oNo, I do not waive my right to access, and I may someday choose to see this form or any ot uments submitted by me oer recommendations or supporting doer recommendations or supporting doer r o doer r o do

n my behalf to the institution an my behalf to the institution at which I enrolling, if that institution saves them after I mt which I enrolling, if that institution saves them after I m riculate.riculate.ricric

Have there been any changes to the senior year courses listed on the original School Report? Yes No

Have there been any changes in the applicants disciplinary status at your school since you submitted the original School Report? Yes No School policy prevents me from responding

To your knowled e, have there been any changes to the applicants criminal history since you submitted the original School Report? Yes No School policy prevents me from responding

Do you wish to update your original evaluation of this applicant? Yes No

CAID __________________________________ ________________________


13/13

2011-12For Spring 2012 or Fall 2012 Enrollment

TO THE APPLICANT

After completing the information in this section, give this form to your school counselor or another school official who knows you better. If applying via mail, please alsgive that school official stamped envelopes addressed to all institutions requesting a final transcript.



Address _________________________________________________________________________________________ ______________Number & Street Apartment # City/Town State/Province Country ZIP/Postal C

chool you now attend ________________________________________________________ CEEB/ACT Code _ ________

Counselors Name (Mr./Mrs./Ms./Dr.) _____________________ ___________________________________________Please print or type

ignature _______________________________________ ____________________________ Date __________________mm/dd/yyyy

Title ____________________________________ _____________________________________ ______________

chool Address _______________________ _________________________________________________________

Number & Street City/Town State/Province Country ZIP/Postal Code

chool Website Address ___________ ______________________________________________________________

Counselor Telephone (_______) ___________ Counselors Fax (_______) ______________________________________ Area/Country/City Code Number Ext. Area/Country/City Code Number

chool CEEB/ACT Code __ __ Counselors E-mail _______________________________________________________

TO THE SCHOOL COUNSELOR

Please submit this form when final grades are available (end of second semes official transcript and transcript legend.(Please check transcript copies for readability.) Be sure to sign below bef versity admission office. Do not mail thisform to The Common Application offices.

Fem Ma

F

Background Information ow has changed for this student since the Midyear Report was submitted, please enter the new informatiin the appropriat

If you responded yes to any of the preceding questions, please attach an explanation.

Ch k h if ld f t di thi li t th h ith h d i i ffi

CClass Rank _______ a period from _______ to ______.lass Rank _______ a period from _______ to ______.(mm/yyyy) (mm/yyyy)

The rank isThe rank is weightedweighted

How many additional student rank?__________How many additional student rank?__________

We do not rank. Instead, please ndicate quartile ____ quintile ____ decile ______We do not rank. Instead, please ndicate quartile ____ quintile ____ decile ______

Cumulative GPA: _____ on a _____ scale, covering a period from _______ to ____Cumulative GPA: _____ on a _____ scale, covering a period from _______ to ____(mm/yyyy) (mm/y

This GPA isThis GPA is

weightedweighted

unweighted. The schools passing mark is ___________unweighted. The schools passing mark is ___________Highest GPA in class _____________________ Graduation Date _____________Highest GPA in class _____________________ Graduation Date _____________

(mm/dd/yyyy)

_______________Countryun t

__________________________ _____ __

__________________________________ __lease print or typerint or

_________________________________ _____ __

__________________________ __ Schoo

_______________________________ ___

City/Toity/T n

_____________________________________ ___ __

______________________________ _ ____y/City Codey/Ci umber

_________________________________ ___ ____

L COUNSELOOOR

er or third trimester). Attach applicantthir r). icante mailing directly to the college/und e c

mationmm If any of the information bef an inforsection below.se

Class Size ______ CoveriClass Size ______ CoveriCl izeCl ize

unweighted.unweighted.unun

share thisshare thissharshar

IMPORTANT PRIIMPORTANT PRIVVACY NOTE:ACY NOTE: In accordance with the Family Educational Rights and Privacy Act (FERPA), th ur behalfIn accordance with the Family Educational Rights and Privacy Act (FERPA), th ur behalforiginal School Report submitted on yoriginal School Report submitted on yrigin epo on yrigin epo on yreflects your choice to waive or not waive your right of access to all recommendations and supporting d ubsequent reportreflects your choice to waive or not waive your right of access to all recommendations and supporting d ubsequent reportcuments. That response applies to allcuments. That response applies to allc That e ac That e aincluding this one. You chose the following:including this one. You chose the following: Yes, I do waive my right to access, and I understand I will never see this form or any other reco y behalf. Yes, I do waive my right to access, and I understand I will never see this form or any other reco y behalf.mendations submitted by me or onmendations submitted by me or onm me r om me r o No, I do not waive my right to access, and I may someday choose to see this form or any ot uments submitted by me oNo, I do not waive my right to access, and I may someday choose to see this form or any ot uments submitted by me oer recommendations or supporting doer recommendations or supporting doer r o doer r o do

n my behalf to the institution an my behalf to the institution at which I enrolling, if that institution saves them after I mt which I enrolling, if that institution saves them after I m riculate.riculate.ricric

Have there been any changes to the senior year courses listed on the original School Report? Yes No

Have there been any changes in the applicants disciplinary status at your school since you submitted the original School Report? Yes No School policy prevents me from responding

To your knowled e, have there been any changes to the applicants criminal history since you submitted the original School Report? Yes No School policy prevents me from responding

Do you wish to update your original evaluation of this applicant? Yes No

final Report

CAID ___________________________________ _______________________

Documents

2012 11CAO Highlighted 1