Teacher Recommendation - Cheyney University

CHEYNEY UNIVERSITY O F P E N N S Y L V A N I A

CHEYNEY, PENNSYLVANIA 19319

1-800-CHEYNEY 1-800-243-9639 (601) 339-2275

SECONDARY SCHOOL REPORT

TO THE APPLICANT:
Complete the top portion of this form and give it to your Guidance Counselor.
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APPLICANT'S NAME

^Last

^First

^Middle

^Maiden

___________________________________________________________________________________________________________________________

ADDRESS

^Street

^City

^State

^{Zip Code}

___________________________________________
SOCIAL SECURITY NUMBER (REQUIRED)

TO THE COUNSELOR:
The student named above is applying for admission to Cheyney University. Please complete all items below and attach a copy of the student's official high schoool transcript containing a record of all courses and grades earned through the most recently completed semester. All courses currently in progress must also be listed.
___________________________________________________________________________________________________________________________

NAME OF HIGH SCHOOL

CEEB CODE

1. School is public ( ) Private ( ).
2. Guidance Office Telephone (________)_____________________________
3. The student's rank is _________ in a class of _________ students.
4. Rank is estimated( ) computed( ).
5. Check appropriate rank information. This student's rank is based on which of the following

( ) All students
( ) College prep. student only
( ) All subjects given credit
( ) Major subjects only
( ) other ranking policy (explain) _____________________________

6. The student's cuulative Grade Point Average is _________ on a scale of _________.

7. Indicate below the number of units completed and/or scheduled by this student.

	English	Mathematics	Laboratory Science	Foreign Language	Other	U.S. History	Economics	Government	Additional Social Studies	P.E. Or ROTC
Completed
Scheduled

Comments and Recommendations:

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Name (printed)

Title

______________________________________________________________________________________________________

Date

Signature