ADLAI E. STEVENSON HIGH SCHOOL COLLEGE RECOMMENDATION FORM

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1 ADLAI E. STEVENSON HIGH SCHOOL COLLEGE RECOMMENDATION FORM Recommender Use Only EARLIEST DUE DATE November 1 (Must be received by October 1) December 1 (Must be received by November 1) January 1 (Must be received by December 1) Today s Date Early Decision/Early Action Rolling Admission Check here if you will be submitting or have submitted a Common Application Complete this form and make an appointment to submit it to your recommender(s). Name: ID# First Middle Last Date of Birth Cell # Check here if you are the first person in your family to attend college. If not, please complete the following section: I. FAMILY College attended by: Check the highest degree earned by each: Mother 4 yr Bachelor Master s Doctorate Father 4 yr Bachelor Master s Doctorate Brother(s) 4 yr Bachelor Master s Doctorate 4 yr Bachelor Master s Doctorate Sister(s) 4 yr Bachelor Master s Doctorate 4 yr Bachelor Master s Doctorate Is there a college to which you are applying that holds a special tradition in your family s history? II. STEVENSON ACTIVITIES (check years participated) Activity Description of involvement

2 III. COMMUNITY/NON-STEVENSON ACTIVITIES (Religious organizations, summer programs, volunteer work, etc.) Activity (check years participated) Description of involvement IV. WORK EXPERIENCE Employer Position/Title Hrs./Week Length of employment V. COLLEGE/CAREER GOALS AND ACADEMIC INTEREST Please list all colleges to which you are applying that REQUIRE a counselor letter of recommendation. Please list all colleges to which you are applying that DO NOT REQUIRE a counselor letter of recommendation. What major/area of study are you considering for college ( undecided is ok)? What career(s) are you considering pursuing?

3 Do you feel that your transcript accurately reflects your academic ability? If no, explain what factors/circumstances have interfered with your academic performance? What do you think are your academic strengths? List three faculty or staff members (preferably junior year) who could give you a positive appraisal. For teacher recommendations, what did you get out of the teacher s class? VI. PERSONAL Who are your personal heroes, men and women you admire, and why? What special interests or hobbies do you pursue outside of school? What personal experience, summer experience, school/work experience, or travel has been of significant importance to you, and why? Is there any information you would like for me to emphasize in my recommendation to help the colleges make a more accurate appraisal of your application? Let me know what else you would like me to include or emphasize.

4 SELF-EVALUATION Read the statements and rate yourself using the scale below. RATINGS Below Avg. Average Good Excellent Outstanding Ability to organize/use time Self-confidence Desire to learn new things Willingness to take risks Ability to get along with others Willingness to work hard Imagination/Creativity Ability to express self Sense of humor Concern for others Emotional maturity Reaction to setbacks Understanding new concepts Self-discipline Growth potential Leadership Energy Motivation Warmth of personality Personal initiative Respect accorded to faculty

5 Please pick five descriptive words and provide an example how each word applies to you. Examples: I am very creative. I work on the Half-Wit and Wit magazines and I had some of my photos featured in the publication. I work part-time designing gift baskets. or I am very analytical. I can quickly solve problems in Math and Science class. I was the mathlete for several weeks in Advanced Algebra earning the highest score on the first semester final exam. I have been a member of TYMP since my freshman year. accountable diplomatic knowledgeable realistic active discerning reflective adaptable disciplined leader reliable adept discrete logical resourceful aggressive economical loyal respected alert effective responsible ambitious efficient mature responsive analytical empathetic methodical articulate energetic mobile self-directed assertive enterprising motivated self-reliant attentive enthusiastic sense-of-humor experienced objective sensitive broad-minded expert observant serious capable expressive open-minded sincere charismatic extroverted optimistic skilled clever organized sophisticated collaborative fair outgoing spontaneous committed forceful stable communicative patient stimulating competent goal-oriented perceptive strong concise persevering sympathetic confident helpful personable systematic conscientious honest persuasive consistent humorous pleasant tactful constructive poised talented conversant imaginative positive team-member cooperative implementer practical tenacious creative improviser precise tolerant critical independent problem-solver curious industrious productive understanding innovative professional decisive instinctive proficient versatile dependable intelligent proven vigorous determined intuitive Type your sentences using five words from the list above. warm well-read well-rounded

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