Bucknell University Office of Admissions
Bucknell University 
Lewisburg, Pennsylvania 17837 
Phone (570) 577-1101
To be filed:
By November 15 for Early Decision I
By January 1 for Early Decision II
By January 1 for Regular Admission
 
SCHOOL REPORT
SECONDARY SCHOOL COUNSELOR EVALUATION

This secondary school report should be filed with Bucknell before January 15th; the student application form is to be filed before January 1st.

TO THE APPLICANT:

After filling in the information below, give this form to your college counselor.

Birthdate: ________________________   Social Security Number (optional): ____________________

Student name: _________________________________________________________________________________________________________
Last First Middle (complete) Jr. etc.
Address: ______________________________________________________________________________________________________________
Street City or Town State Zip/Postal Code Country

Current Year Courses - Please indicate title, level (AP, IB, advanced, honors, etc.), and term of all courses you are taking this year:

First Semester/Trimester:

_________________________
_________________________
_________________________
_________________________
_________________________

 Second Semester/Trimester:

_________________________
_________________________
_________________________
_________________________
_________________________

 Third Semester/Trimester:

_________________________
_________________________
_________________________
_________________________
_________________________

TO THE SECONDARY SCHOOL COLLEGE COUNSELOR:

Attach applicant's official transcript, including courses in progress, a school profile, and transcript legend. (Please check transcript codes for readability.) After filling in the blanks below, use all of this form to describe the applicant. Please provide all available information for this candidate.
H.S. graduation date: _______
Class rank _______ in a class of _______ students, covering a period from (mo./yr.) _______ to (mo./yr.) _______.
The rank is   __   weighted   __   unweighted. How many students share this rank? _______
If a precise rank is not available, please indicate rank to the nearest tenth from the top. _______
Cumulative GPA: _______ on a _______ scale, covering a period from (mo/yr) ______ to (mo/yr) _______.
The GPA is   __   weighted   __   unweighted.
Percentage of graduating class attending: four year:_______   two-year:_______ institutions.
In comparison to other college preparatory students at our school, the applicant’s course selection is:
__ most demanding __ very demanding __ demanding __ average __ less than demanding.
Are courses taken on a block schedule?   __   Yes   __   No   If yes, in what year did block scheduling begin? _______

Counselor's name (please print or type):___________________________ Signature:________________________
Position:__________________________ School:__________________________________
Counselor's Address:_________________________________________________
Counselor's Phone: (______) ________________ Counselor's fax: (_____) ____________
High School CEEB/ACT Code:____________ Counselor's email:________________

Please write whatever you think is important about the applicant, including a description of academic and personal characteristics. We are particularly interested in the candidate's intellectual promise, motivation, maturity, integrity, independence, originality, initiative, leadership potential, capacity for growth, special talents, enthusiasm, concern for others, respect accorded by faculty, and reactions to setbacks. We welcome information that will help us to differentiate this student from others.

How long have you known the applicant, and in what context?
__________________________________________________________________________________
What are the first words that come to your mind to describe the applicant?
_____________________________________________________________________

RATINGS (OPTIONAL)

Compared to other college-bound students in his or her secondary class, how do you rate this student in terms of:
No BasisBelow AverageAverageGood (above average)Very Good (well above average) Excellent (top 10%)one of the top few encountered in my career
  Academic Achievement            
  Extracurricular Accomplishments            
  Personal Qualities and Character            
  Creativity            

I recommend this student:  

  with reservation     fairly strongly     strongly     enthusiastically

CONFIDENTIALITY

We value your comments highly and ask that you complete this form in the knowledge that it may be retained in the student's file should the applicant matriculate at a Bucknell University. In accordance with the Family Educational Rights and Privacy Act of 1974, matriculating students do have access to their permanent files which may include forms such as this one. Colleges do not provide access to admissions records to applicants, those students who are denied admission, or those students who decline an offer of admission. Again, your comments are important to us and we thank you for your cooperation. We are committed to administer all educational policies and activities without discrimination on the basis of race, color, religion, national or ethnic origin, age, handicap, or sex. The admissions process at private undergraduate institutions is exempt from the federal regulation implementing Title IX of the Education Amendments of 1972.