File online at America s Leading College for Students with Learning Disabilities and AD/HD

Transcription

1 File online at Application for Admission America s Leading College for Students with Learning Disabilities and AD/HD Putney, Vermont

2 Help us get to know you. Let me begin by saying thanks for your interest in Landmark College. As you probably already know, we re not like most other colleges, because our focus is exclusively on students who seek a different path as they pursue their baccalaureate degree. Because we re committed to providing educational strategies and opportunities for students with learning disabilities, this application seeks information designed to help us get to know you as fully as possible. In completing this application, remember that s our goal. While you ll see questions about grades and past performance, please know we recognize these factors may not be the best indication of your full potential. The Admissions Committee will be looking at your application from many perspectives to determine if Landmark is a good fit for you. So grab a pen, relax and answer each section as openly as possible. Help us understand why coming to Landmark is the path you seek. If you have any questions or need assistance with some sections, please don t hesitate to call. We re here for you! Dale M. Herold Vice President, Enrollment Management P.S. To simplify things, we ve provided a step-by-step check list for your reference. Freshman applicants should see page 1; transfer students should consult page 2. You can also file online at CONTENTS 1 Checklist for Freshman Applicants 2 Checklist for Transfer Applicants 3 Application for Admission 11 Personal Statement 13 High School Report 15 Instructor Recommendation 17 College/University Report for Transfer Admission 19 Professor Recommendation for Transfer Admission

3 CHECKLIST FOR Freshman Applicants PREFER TO FILE ONLINE? Landmark College is a Universal College Application school. You can file online at Landmark College follows a rolling admissions process. However, to be considered for priority enrollment, freshman applicants for the spring semester should apply by Dec.1; applicants for the fall semester should apply by April 1. Use this helpful check list to ensure you provide the necessary information for a complete application. b A completed and signed application b $75 application fee, made payable to Landmark College The fee is required unless you submit a fee waiver request. b Official high school transcript(s) Complete through seven semesters or the semester most recently completed. Transcripts of any summer school or college work must be submitted as well. Your final transcript is required prior to enrollment. Home-schooled students are reviewed on a case by case basis. Please submit supporting documentation of curriculum and certification. Note: IEP diplomas are rarely accepted. b Copy of GED (if applicable) b Cognitive testing (must have been administered within three years of applying) The Wechsler Adult Intelligence Scale III (WAIS III), Wechsler Intelligence Scale for Children (WISC) or the Woodcock Johnson Cognitive Test are acceptable. These tests are comprised of a series of standardized tests used to evaluate the cognitive and intellectual abilities of students. Complete scores including subtests are required to provide a comprehensive understanding of the applicant. b Nelson-Denny reading scores (must have been administered within one year of applying) Gives a three-dimensional picture of your reading abilities by measuring your vocabulary development, reading comprehension and reading rate. If you have questions about this test or need assistance in locating a test administrator call Landmark s Office of Admissions at b Diagnosis of a learning disability or AD/HD (must have been diagnosed within three years of applying) Current diagnosis of a learning disability or AD/HD by a professional is a requirement for admission to Landmark College. b High school report b Instructor recommendation This should be completed by a teacher in an academic subject who knows you well. You may submit additional recommendations from teachers. b Personal statement b TOEFL (for International Students) Applicants for whom English is not their first language must submit scores from the Test of English as a Foreign Language (TOEFL). OPTIONAL b SAT/ACT scores We do not place heavy emphasis on the SAT or ACT scores, but we do find that they add to our understanding of the applicant. FINANCIAL AID DEADLINES The priority application deadline for students wishing to be considered for financial aid is April 1 for the Fall semester and December 1 for the Spring semester. b FAFSA Free Application for Federal Student Aid (available online at 1

4 CHECKLIST FOR Transfer Applicants PREFER TO FILE ONLINE? Landmark College is a Universal College Application school. You can file online at Landmark College follows a rolling admissions process. However, to be considered for priority enrollment, transfer applicants for the spring semester should apply by Dec. 1; transfer applicants for the fall semester should apply by June 1. Use this helpful check list to ensure you provide the necessary information for a complete application. b The completed and signed application b $75 application fee, made payable to Landmark College The fee is required unless you submit a fee waiver request. b Official transcripts of all college work b Official final high school transcript(s) Home schooled students are reviewed on a case by case basis. Please submit supporting documentation of curriculum and certification. Note: IEP diplomas are rarely accepted. b Copy of GED (if applicable) b Cognitive testing (must have been administered within three years of applying) The Wechsler Adult Intelligence Scale III (WAIS III), Wechsler Intelligence Test for Children (WISC) or the Woodcock Johnson Cognitive Test are acceptable. These tests are comprised of a series of standardized tests used to evaluate the cognitive and intellectual abilities of students. Complete scores including subtests are required to provide a comprehensive understanding of the applicant. b Nelson-Denny reading scores (must have been administered within one year of applying) Gives a three-dimensional picture of your reading abilities by measuring your vocabulary development, reading comprehension and reading rate. If you have questions about this test or need assistance in locating a test administrator call Landmark s Office of Admissions at b Diagnosis of a learning disability or AD/HD (must have been diagnosed within three years of applying) Current diagnosis of a learning disability or AD/HD by a professional is a requirement for admission to Landmark College. b College/university report b Professor recommendation b Personal statement b TOEFL (for International Students) Applicants for whom English is not their first language must submit scores from the Test of English as a Foreign Language (TOEFL). OPTIONAL b SAT/ACT We do not place heavy emphasis on the SAT or ACT scores, but we do find that they add to our understanding of the applicant. FINANCIAL AID The priority application deadline for students wishing to be considered for financial aid is April 1 for the Fall semester and December 1 for the Spring semester. b FAFSA Free Application for Federal Student Aid (available online at 2

5 Office Use Only PMT DATE AMT Application for Admission I am applying for the term beginning What is your intended area of study at Landmark? b Business Administration b Liberal Arts b Business Studies b General Studies Have you previously attended Landmark College (including any summer programs)? b Yes b No If yes, when: PAYMENT INFORMATION Are you planning to apply for a counselor-approved waiver of your application fee? b Yes b No Are you applying for financial aid? b Yes b No If you are applying for financial aid, when did/will you file the FAFSA? PERSONAL INFORMATION Please enter your name as it appears on your passport or other official documents. Legal Name b Male b Female Last (Family) First Middle Suffix (Jr., Sr., etc.) Preferred Name Previous Last Name(s), if any Date of Birth Marital Status (mm/dd/yyyy) (single, married, etc.) PERMANENT ADDRESS Street Address Apt. # Phone ( ) Alternate Phone ( ) Begin with Area or Country Code Begin with Area or Country Code Please give your current address for all admission correspondence, if different from above. CURRENT MAILING ADDRESS Street Address Apt. # Current Mailing Address Phone ( ) Current mailing address valid from to Begin with Area or Country Code (mm/dd/yy) (mm/dd/yy) CITIZENSHIP Place of Birth City/Town State/Province Country b US Citizen b Dual US citizen; please specify other country of citizenship b US permanent resident visa; citizen of Alien registration number b Other Citizenship Visa If you live in the United States, but are not a U.S. citizen, how many years have you lived in the country? If not English, language spoken in your home If not English, list your first language 3

6 ETHNICITY Race/Ethnicity information is optional. Information you provide will not be used in a discriminatory manner. Are you Hispanic or Latino? b Yes b No (country of family s origin ) How would you describe your racial background? (select one or more of the following categories): b Asian (country of family s origin) b Native Hawaiian or Other Pacific Islander b Black or African American b American Indian or Alaska Native FAMILY INFORMATION 4 b White PARENT/GUARDIAN #1 b Parent b Guardian Title Last (Family) First Middle Suffix b Male b Female Living? b Yes b No (Date Deceased ) (mm/yyyy) If different from yours Address Street Address Apt. # Phone ( ) Begin with Area or Country Code Profession Position Employer College Attended (if any) Graduate School Attended (if any) Degree Earned Year Highest Degree Earned Year PARENT/GUARDIAN #2 b Parent b Guardian Title Last (Family) First Middle Suffix b Male b Female Living? b Yes b No (Date Deceased ) (mm/yyyy) If different from yours Address Street Address Apt. # Phone ( ) Begin with Area or Country Code Profession Position Employer College Attended (if any) Graduate School Attended (if any) Degree Earned Year Highest Degree Earned Year Your parents are If divorced, list date (married, divorced, etc.) (mm/yyyy) With whom do you reside? b Both b Parent/Guardian #1 b Parent/Guardian #2 b Other (Explain) List names, genders, and ages of your siblings, college (if any), degree(s), and dates of attendance. Name Gender Age Institution Degree(s) Dates

7 HIGH SCHOOL ACADEMIC INFORMATION Note: This section must also be completed by transfer applicants. School CEEB Code Type of school: b Public b Private b Correspondence b Charter b Parochial b Home-School b Other/Education Provider School Address Number and Address Start Date Date of Graduation (mm/yyyy) (mm/yyyy) Counselor s Name Phone ( ) Begin with Area or Country Code Counselor s Fax ( ) Begin with Area or Country Code Are you currently enrolled in school? b Yes b No Will/did you graduate from High School early? b Yes b No Did you receive a GED? b Yes b No If so, list date: (Please send official scores from testing agency) (mm/yyyy) OTHER HIGH SCHOOLS List all other high schools, colleges/universities (including summers), and academic programs you attended, beginning with ninth grade. You must submit transcripts from each school. School Name CEEB Code Dates Attended Location COLLEGES/UNIVERSITIES Please list any colleges or universities you attended while still in high school. Official transcripts are required. (Transfer students should provide college information requested on page 7.) School Name CEEB Code Dates Attended Location LEARNING DIAGNOSIS INFORMATION Have you been diagnosed with a learning disability or AD/HD? b Yes b No If yes, what was the diagnosis: Date of diagnosis: 5

8 STANDARDIZED TEST INFORMATION (optional) List your test scores below. SAT Reasoning Test Date Verbal/ Math Writing Test Date Verbal/ Math Writing Critical Reading Critical Reading Test Date Verbal/ Math Writing Critical Reading SAT Subject Test Date Subject Score Test Date Subject Score Test Date Subject Score Test Date Subject Score Test Date Subject Score Test Date Subject Score ACT Test Date English Math Reading Science Composite Combination English/Writing Test Date English Math Reading Science Composite Combination English/Writing Test Date English Math Reading Science Composite Combination English/Writing TOEFL/Test of English as a Foreign Language (required for international students) Paper-Based Internet-Based Date Subject Score Date Subject Score Computer-Based Date Subject Score AP/IB TEST SCORES (optional) Please list any Advanced Placement or International Baccalaureate exams taken along with the test date and score. Test Date Subject Score Test Date Subject Score Test Date Subject Score Test Date Subject Score Test Date Subject Score Test Date Subject Score ACADEMIC DISTINCTIONS Please list any academic or educational awards and honors you received in high school below (e.g. National Merit, National Honor Society). If additional space is needed, please attach your response to the end of the application. 6

9 COLLEGE ACADEMIC INFORMATION FOR TRANSFER STUDENTS Current Institution CEEB Code Institution Type: b Public b Private b Proprietary Institution s Address Number and Address Start Date Date of Graduation (if applicable) (mm/yyyy) (mm/yyyy) Advisor s Name Phone ( ) Begin with Area or Country Code Advisor s Fax ( ) Begin with Area or Country Code Are you currently enrolled in a college or university? b Yes b No Did you graduate from high school early? b Yes b No Did you receive a GED? b Yes b No If so, list date: (Please send official scores from testing agency) (mm/yyyy) CURRENT YEAR S COURSES Please list name, level (introductory-level, upper-level, etc.) and credit value of your current year s courses. Semester #1/Trimester #1 Semester #2/Trimester #2 Trimester #3 OTHER COLLEGES/UNIVERSITIES ATTENDED List all colleges or universities you have attended. Official transcripts must be provided. School Name CEEB Code Dates Attended Location 7

10 EXTRACURRICULAR AND VOLUNTEER INFORMATION To be completed by all applicants. Please list any significant extracurricular or community activities and hobbies (including summer) in which you have participated. Include specific accomplishments such as musical accolades, athletic distinctions, etc. (Please note: C means College) Activity Grade Level Specific Accomplishments Hours/ Weeks/ Will you participate Week Year in college? b 9 b 10 b 11 b 12 b C b Yes b No b Unsure b 9 b 10 b 11 b 12 b C b Yes b No b Unsure b 9 b 10 b 11 b 12 b C b Yes b No b Unsure b 9 b 10 b 11 b 12 b C b Yes b No b Unsure b 9 b 10 b 11 b 12 b C b Yes b No b Unsure b 9 b 10 b 11 b 12 b C b Yes b No b Unsure b 9 b 10 b 11 b 12 b C b Yes b No b Unsure EMPLOYMENT INFORMATION List any work experience (including summer jobs) during the past three years. Employer Job Description Dates of Employment Hours per week ACTIVITY DESCRIPTION Tell us more about one of your extracurricular, volunteer, or employment activities ( words). If you need more space, please attach your response to the end of the application. 8

11 MULTIMEDIA INFORMATION Optional: In addition to your personal statement (see page 11) you may also provide us with a link to any online content you feel: 1. Tells Landmark College more about yourself 2. Demonstrates a particular talent you possess 3. Highlights an activity in which you participated Some ideas include linking to an online video you created, a portfolio (pictures or photographs), a musical composition, or a newspaper article. Please briefly describe the contents of the link you provided. ADDITIONAL INFORMATION Who or what factors led you to apply to Landmark College? Please list any other colleges to which you are applying: If you have not been enrolled in high school or college for the past six months, please indicate how you have spent your time (i.e., travel, work, military service, etc.): If you have additional information that was not specifically requested on the application or did not fit in the space provided, feel free to include it here. If you need more space, please attach your response to the end of the application. DISCIPLINE INFORMATION Have you ever been placed on probation, suspended, removed, dismissed or expelled from any school or academic program since 9th grade? Other than traffic offenses, have you ever been convicted of any misdemeanor, felony, or other crime? If you answered yes to either question, please provide an explanation and the approximate dates of each incident. Please attach your response to the end of the application. b Yes b No b Yes b No 9

12 AUTHORIZATION By applying to Landmark College and signing this application for admission, I indicate my understanding that Landmark offers an intensive, rigorous academic program focused on the liberal arts. The college provides extensive academic and student services designed to help students achieve academically, within a residential environment typical of that of a small liberal arts college. I understand that classes, including workshops and office hours, meet for up to six hours per week, and to succeed in the program, I must be prepared to attend class meetings and do up to three hours of coursework per night. I recognize that students who are motivated to meet Landmark s high standards and expectations generally succeed academically and are able to transfer to baccalaureate degree programs of their choosing. I also understand that students not prepared to work in an intensive academic environment, or who may have issues secondary to academic performance that require their focus, may have difficulty achieving the learning outcomes of the program. Note: Landmark College reserves the right to waive requirements or request additional information as necessary to reach an admissions decision. My signature below indicates that the information in my application is correct and honestly presented. Signature of applicant Date Landmark College admits students of any race, color, and national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of color, gender, national and ethnic origin, or sexual orientation in the administration of its educational policies, scholarship and loan programs, and athletic and other college-administered programs. Mail completed form to: Landmark College, Office of Admissions, P.O. Box 820, Putney, VT

13 Applicant s Personal Statement Required of all candidates for admission to Landmark College. Student s Name First Middle Last When deciding who will be offered admission to Landmark College, the Admissions Committee considers many factors such as your academic motivation, expectations of commitment to the support systems and our academic model, academic goals and the nature of your learning disability. Please write an essay that demonstrates your ability to develop and communicate your thoughts. In 500 words or fewer, critically evaluate your educational history. (If you have previously attended a college or university, we ask that you focus your comments on that experience.) We want you to demonstrate your understanding of any challenges you have faced up to this point. In this essay you might consider one or more of the following questions: What are your strengths as a learner? What are your challenges? What skills and strategies are you hoping to develop at Landmark College? Are there any educational accommodations that you require to achieve your true potential? Are there any educational practices that make it difficult for you to demonstrate your abilities? continued 11

14 Mail completed form to: Landmark College, Office of Admissions, P.O. Box 820, Putney, VT

15 High School Report Please type or print neatly. APPLICANT INFORMATION Please complete the applicant information questions below, then give this form to your high school counselor. For ease of submission, please provide your counselor with a stamped envelope addressed to: Office of Admissions, Landmark College, P.O. Box 820, Putney, VT Please enter your name as it appears on your passport or other official documents. Legal Name Last (Family) First Middle Suffix (Jr., Sr., etc.) b Male b Female Date of Birth (mm/dd/yyyy) Address Street Address Apt. # Current School CEEB Code WAIVER OF ACCESS I have requested that this report be filled out by school officials for use in the admissions process and in counseling by officials of Landmark College. In accordance with the Family Educational Rights and Privacy Act of 1974, I have indicated my intention regarding access to these reports by checking one of the following options: b I waive access to this report, which shall therefore be considered confidential. b I do not waive access to this report. Student s Signature Date NOTE: If you agree to the waiver printed above, we will preserve the strict confidentiality of this document, and it will be made available only to Landmark College officials. If you have not agreed, this report will be made available to you, upon request, if you become a student at Landmark College. COUNSELOR INFORMATION Landmark College is the nation s premier accredited college designed exclusively for students of average to superior intellectual potential who have dyslexia, AD/HD, or specific learning disabilities. Your assistance is needed in providing an academic profile for this candidate for admission. Please complete this form. If needed, attach additional sheets. Counselor s Name Position Counselor s Phone Counselor s Begin with Area or Country Code School CEEB Code School Address Street Address Please list name, level (Honors, AP, IB, etc.) and credit value of this student s current year s courses. 13

16 ACADEMIC INFORMATION Please answer the questions below. Attach to this form an official transcript, including current courses, a school profile, and transcript legend. Student s dates of attendance used to calculate class rank (if applicable) and cumulative grade point average to (mm/yyyy) (mm/yyyy) CLASS RANK Does your school rank students? b Yes b No If yes, what is the class rank of this student: out of Do any students share this rank? b Yes b No If so, how many? Is the rank weighted? b Yes b No CUMULATIVE GPA This student s GPA is on a scale of Is the GPA weighted? b Yes b No Your school s passing grade is Highest GPA in class Graduation date (mm/yyyy) SCHOOL PROFILE Link to School Profile (optional): Percentage of graduating class attending four-year institutions two-year institutions In comparison with other college-bound students attending your school, the student's course selection is b Less than challenging b Average challenging b Very challenging b Most challenging BACKGROUND INFORMATION For how long have you known this applicant and in what capacity? Briefly describe your overall impression of this applicant. APPLICANT RATINGS Please rate this student compared to other college-bound students in her or his class (b I prefer not to participate in the applicant ratings section) No Ability to Judge Below Average Average Above Average Excellent Outstanding Academic Success b b b b b b Extracurricular Success b b b b b b Character b b b b b b Overall b b b b b b EVALUATION Please attach your evaluation of this applicant to this form. Include your thoughts about academic and personal characteristics. Institutions are particularly interested in information that will help to differentiate this applicant from others. Overall, I recommend this student for admission b Not at all b With reservations b Fairly strongly b Strongly b Enthusiastically Has the applicant ever been placed on probation, suspended, removed, dismissed or expelled from your school? b Yes b No Has the applicant ever been convicted of any misdemeanor, felony, or other crime? b Yes b No If you answered yes to either question, please provide an explanation and the approximate dates of each incident below. If necessary please attach your response to the end of this form. Your signature indicates that all information on this form is factually true and honestly presented and that you are the person submitting this form. Signature of counselor Date 14

17 Instructor Recommendation Please type or print neatly. APPLICANT INFORMATION Please complete the applicant information questions below, then give this form to a teacher of your choosing who knows you well. For ease of submission, please provide your teacher with a stamped envelope addressed to: Office of Admissions, Landmark College, P.O. Box 820, Putney, VT Please enter your name as it appears on your passport or other official documents. Legal Name Last (Family) First Middle Suffix (Jr., Sr., etc.) b Male b Female Date of Birth (mm/dd/yyyy) Address Street Address Apt. # Current School CEEB Code WAIVER OF ACCESS I have requested that this report be filled out by school officials for use in the admissions process and in counseling by officials of Landmark College. In accordance with the Family Educational Rights and Privacy Act of 1974, I have indicated my intention regarding access to these reports by checking one of the following options: b I waive access to this report, which shall therefore be considered confidential. b I do not waive access to this report. Student s Signature Date NOTE: If you agree to the waiver printed above, we will preserve the strict confidentiality of this document, and it will be made available only to Landmark College officials. If you have not agreed, this report will be made available to you, upon request, if you become a student at Landmark College. INSTRUCTOR INFORMATION The above-named student has applied to Landmark College, which is the nation s premier accredited college designed exclusively for students of average to superior intellectual potential who have dyslexia, AD/HD, or specific learning disabilities. Please write a description of the candidate. Include your thoughts about his/her motivation, academic performance, honesty, ability to set realistic goals, interpersonal skills, sense of humor, and any other observations relevant to his/her performance in a college setting. In addition, because of the specialized nature of our program, any information that would help us to respond successfully to the student s learning needs is especially helpful. Instructor s Name Position Instructor s Phone Instructor s Begin with Area or Country Code School CEEB Code School Address Street Address 15

18 BACKGROUND INFORMATION For how long have you known this applicant and in what capacity? Briefly describe your overall impression of this applicant. List the courses you taught this applicant. Please include the course level of difficulty (honors, AP, IB, etc) and the year in which you taught the applicant (i.e., sophomore, junior, senior). APPLICANT RATINGS Please rate this student compared to other college-bound students in her or his class (b I prefer not to participate in the applicant ratings section) ACADEMIC No Ability to Judge Below Average Average Above Average Excellent Outstanding Academic Success b b b b b b Intellectual Ability b b b b b b Written Expression b b b b b b Creative Qualities b b b b b b Academic Involvement b b b b b b CHARACTER/ PERSONALITY TRAITS No Ability to Judge Below Average Average Above Average Excellent Outstanding Respect for Others b b b b b b Initiative b b b b b b Personal Leadership/Influence b b b b b b Emotional Maturity b b b b b b Self-Confidence b b b b b b Self-Discipline b b b b b b Character and Integrity b b b b b b Potential for Growth b b b b b b EVALUATION Please evaluate this applicant and include your thoughts about academic and personal traits. We are particularly interested in information that will help to differentiate this applicant from others. Feel free to include a separate sheet with additional information, as appropriate. Overall, I recommend this student for admission b Not at all b With reservations b Fairly strongly b Strongly b Enthusiastically Your signature indicates that all information on this form is factually true and honestly presented and that you are the person submitting this form. Signature of instructor Date 16

19 College/University Report for Transfer Admission Please type or print neatly. APPLICANT INFORMATION Please complete the applicant information questions below, then give this form to a college official who has access to your collegiate record (i.e., Dean or College Registrar). For ease of submission, please provide the college official with a stamped envelope addressed to: Office of Admissions, Landmark College, P.O. Box 820, Putney, VT Please enter your name as it appears on your passport or other official documents. Legal Name Last (Family) First Middle Suffix (Jr., Sr., etc.) b Male b Female Date of Birth (mm/dd/yyyy) Address Street Address Apt. # Current College/University CEEB Code WAIVER OF ACCESS I have requested that this report be filled out by school officials for use in the admissions process and in counseling by officials of Landmark College. In accordance with the Family Educational Rights and Privacy Act of 1974, I have indicated my intention regarding access to these reports by checking one of the following options: b I waive access to this report, which shall therefore be considered confidential. b I do not waive access to this report. Student s Signature Date NOTE: If you agree to the waiver printed above, we will preserve the strict confidentiality of this document, and it will be made available only to Landmark College officials. If you have not agreed, this report will be made available to you, upon request, if you become a student at Landmark College. COLLEGE OFFICIAL S INFORMATION Landmark College is the nation s premier accredited college designed exclusively for students of average to superior intellectual potential who have dyslexia, AD/HD, or specific learning disabilities. Your assistance is needed in providing an academic profile for this candidate for admission. Please complete this form. If needed, attach additional sheets. Official s Name Position Official s Phone Official s Begin with Area or Country Code College/University CEEB Code College/University Address Street Address 17

20 ACADEMIC INFORMATION Please answer the questions below. Attach to this form an official transcript, including current courses, a school profile, and transcript legend. Student s dates of attendance used to calculate class rank (if applicable) and cumulative grade point average to (mm/yyyy) (mm/yyyy) CLASS RANK Does your school rank students? b Yes b No If yes, what is the class rank of this student: out of Do any students share this rank? b Yes b No If so, how many? Is the rank weighted? b Yes b No CUMULATIVE GPA This student s GPA is on a scale of Is the GPA weighted? b Yes b No Your institution s passing grade is Highest GPA in class Graduation date (mm/yyyy) BACKGROUND INFORMATION For how long have you known this applicant and in what capacity? Briefly describe your overall impression of this applicant. APPLICANT RATINGS Please rate this student compared to other students in her or his class (b I prefer not to participate in the applicant ratings section) No Ability to Judge Below Average Average Above Average Excellent Outstanding Academic Success b b b b b b Extracurricular Success b b b b b b Character b b b b b b Overall b b b b b b EVALUATION Please attach your evaluation of this applicant to this form. Include your thoughts about academic and personal characteristics. Institutions are particularly interested in information that will help to differentiate this applicant from others. What are the applicant s reasons for transferring? 1. Is this applicant in good academic standing and eligible to return to your college/university? b Yes b No 2. Has the applicant ever been placed on probation, suspended, removed, dismissed or expelled from your school? b Yes b No 3. Has the applicant ever been convicted of any misdemeanor, felony, or other crime? b Yes b No If you answered yes to either question two or three please provide an explanation and the approximate dates of each incident below. If necessary please attach your response to the end of this form. Overall, I recommend this student for admission b Not at all b With reservations b Fairly strongly b Strongly b Enthusiastically Your signature indicates that all information on this form is factually true and honestly presented and that you are the person submitting this form. Signature of college official Date 18

21 Professor Recommendation for Transfer Admission Please type or print neatly. APPLICANT INFORMATION Please complete the applicant information questions below, then give this recommendation form to a professor who taught you a full-credit college course and who knows you well. For ease of submission, please provide your professor with a stamped envelope addressed to: Office of Admissions, Landmark College, P.O. Box 820, Putney, VT Please enter your name as it appears on your passport or other official documents. Legal Name Last (Family) First Middle Suffix (Jr., Sr., etc.) b Male b Female Date of Birth (mm/dd/yyyy) Address Street Address Apt. # College/University CEEB Code WAIVER OF ACCESS I have requested that this report be filled out by school officials for use in the admissions process and in counseling by officials of Landmark College. In accordance with the Family Educational Rights and Privacy Act of 1974, I have indicated my intention regarding access to these reports by checking one of the following options: b I waive access to this report, which shall therefore be considered confidential. b I do not waive access to this report. Student s Signature Date NOTE: If you agree to the waiver printed above, we will preserve the strict confidentiality of this document, and it will be made available only to Landmark College officials. If you have not agreed, this report will be made available to you, upon request, if you become a student at Landmark College. PROFESSOR INFORMATION The above-named student has applied to Landmark College, which is the nation s premier accredited college designed exclusively for students of average to superior intellectual potential who have dyslexia, AD/HD, or specific learning disabilities. Please write a description of the candidate. Include your thoughts about his/her motivation, academic performance, honesty, ability to set realistic goals, interpersonal skills, sense of humor, and any other observations relevant to his/her performance in a college setting. In addition, because of the specialized nature of our program, any information that would help us to respond successfully to the student s learning needs is especially helpful. Professor s Name Position Professor s Phone Professor s Begin with Area or Country Code College/University CEEB Code College/University Address Street Address 19

22 BACKGROUND INFORMATION For how long have you known this applicant and in what capacity? Briefly describe your overall impression of this applicant. List the college courses you taught this applicant. Please include the course level of difficulty (introductory-level, upperlevel, etc.) and the year in which you taught the applicant (i.e., freshman, sophomore). APPLICANT RATINGS Please rate this student compared to other students in her or his class (b I prefer not to participate in the applicant ratings section) ACADEMIC No Ability to Judge Below Average Average Above Average Excellent Outstanding Academic Success b b b b b b Intellectual Ability b b b b b b Written Expression b b b b b b Creative Qualities b b b b b b Academic Involvement b b b b b b Motivation b b b b b b Reaction to Setbacks b b b b b b Faculty Respect b b b b b b CHARACTER/ PERSONALITY TRAITS No Ability to Judge Below Average Average Above Average Excellent Outstanding Respect for Others b b b b b b Initiative b b b b b b Personal Leadership/Influence b b b b b b Emotional Maturity b b b b b b Self-Confidence b b b b b b Self-Discipline b b b b b b Character and Integrity b b b b b b Maturity b b b b b b Potential for Growth b b b b b b EVALUATION Please evaluate this applicant and include your thoughts about academic and personal traits. We are particularly interested in information that will help to differentiate this applicant from others. Feel free to include a separate sheet with additional information, as appropriate. Overall, I recommend this student for admission b Not at all b With reservations b Fairly strongly b Strongly b Enthusiastically Your signature indicates that all information on this form is factually true and honestly presented and that you are the person submitting this form. Signature of professor Date 20

23

24 Telephone: Web Site: Putney, Vermont