8/13/2019 6 Secondary School Transcript Request Form

1/2

NameApplicants full legal namelast name rst

Address

Social Security Number (optional) Date of Birth

School Name

Address

Number and Street City/own State/Province Zip/Postal Code

Are you applying under the Early Decision Plan? Yes No

CEEB CODE Entered Withdrew Will graduate month & year month & year month & year

Class Rank

Te candidate ranks ___________ in a class numbering __________ during the period from __________ to __________.

Te rank is weighted unweighted. If there are other students tied at that rank, how many share the same ranking? __________

If a precise rank is not available, indicate the rank to the nearest tenth from the top. __________ We do not rank.

Of last years graduating class, percentage of students attending: four-year __________ two-year __________ college or university.

Grade-Point Average

Te applicants cumulative GPA is __________ on a __________ scale, covering a period from __________ to __________.

Tis GPA is weighted unweighted. Te applicants highest possible GPA is __________.

Your schools minimum passing grade is 60 65 70 other (specify) __________.

In comparison to other college preparatory students at your school, this applicants course selection is:

most demanding very demanding demanding average less demanding

Standardized Test Scores

AC ests

Date taken/ English Math Reading Science Composite Writingto be taken

Date taken/ English Math Reading Science Composite Writingto be taken

SA Reasoning estsDate taken/ Critical Math Writing Date taken/ Critical Math Writing Date taken/ Critical Math Writingto be taken Reading to be taken Reading to be taken Reading

SA Subject estsDate taken/ Subject Score Date taken/ Subject Score Date taken/ Subject Scoreto be taken to be taken to be taken

OEFL/IELSDate taken/ est Score Date taken/ est Score Date taken/ est Score

to be taken to be taken to be taken

Counselor Section: (Please note that lack o rank and GPA will make this application more difficult to process)

Applicant Section:

Please ll in the Applicant Section below and give this orm to your secondary schoolcounselor. Be sure to give your counselor time to ll out this orm beore the due date.Afer completing the orm, your counselor should send it to:

Rochester Institute o TechnologyUndergraduate Admissions Office60 Lomb Memorial DriveRochester, NY 14623-5604

Due Dates (Postmark)

Early Decision Plan December 1Regular Decision Plan February 1

Applications completed afer February 1will be reviewed on a rolling basis.

Secondary SchoolTranscript Request

(international

applicants)

8/13/2019 6 Secondary School Transcript Request Form

2/2

Counselor Signature:________________________________________________ Date: ________________________________________

Name (please print): ________________________________________________ itle: ________________________________________

E-mail Address at School:____________________________________________ elephone Number at School:_____________________

Early Decision

Transcript

Prole

I the student is applying under RIs Early Decision Plan (indicated on ront page),please read the ollowing and sign below:

I have discussed Early Decision consideration with this applicant. Te applicant under-stands Early Decision is a rst-choice plan.

_________________________________________________ ____________________ Signature Date

An official copy o the applicants secondary school record should be included with this orm.

Please include a copy o your schools prole (inormation about curriculum, percentageo graduates going on to college, standardized-test scores, and the like).

Counselor Recommendation Please rank applicant in the following categories:

Excellent Outstanding

Below Average Average Above Average (top 10%) (top 5%)

Academic promise

Character and personal promise

Potential for success at RI

Overall

Mainstream ProgramIf applicant is deaf or hard of hearing, please indicate if the student has been mainstreamed and any access/support services received:

Years mainstreamed Interpreter utor Notetaker

Speech-to-text Services Resource Room Self-contained Classroom

Summary and RecommendationPlease write a summary appraisal of the applicant. We are particularly interested in observations about character, motivation, ability, and any

special talent or quality. Please describe any special factors that should be considered in interpreting the applicants record, such as unusual

home conditions or illness. Please dont hesitate to attach a copy of a letter you have already written on behalf of this applicant.