COUNSELOR RECOMMENDATION

(Please sign form at the bottom)

What is the name of the student you are recommending for the Math/Science Program?


What high school does the student attend?


What is your name?

What is the student's G.P.A.? (I possible, please list on a 4.0 scale.)   

What is the rank of the student?


The student is enrolled in: college preparatory curriculum
general curriculum vocational curriculum


Student's Current Schedule:
Math Classes Completed:

Math Courses Planned for Next Year:

Science Classes Completed:

Science Courses Planned for Next Year:

Please supply all applicable test scores of the student:

ACT PLAN
PSAT

ACT (Please list all scores.)

Math:          

Verbal:        

Composite:   
SAT (Please list all scores.)

Math:          

Verbal:        

Evaluate the student's interest in academic work:
Excellent Above Average Average Below Average
Poor


Describe the student's regard to authority and peer collaboration skills:


Evaluate the student's potential or desire to continue his/her education beyond high school:
Excellent Above Average Average Below Average
Poor


Please summarize any special circumstances that have affected the students's progress:


Do you recommend this student for the Math/Science Program?
Enthusiastically With Reservation No


Additional Comments:

Counselor:

Contact Phone Number:

E-mail Address:

Date: