Advanced Scholar Secondary School Report Form
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2G R I N N E L L C O L L E G E
ADVANCED SCHOLAR SECONDARY SCHOOL REPORT FORM
TO THE APPLICANT
Please complete the top portion and then ask your guidance counselor or college adviser to complete the remaining portion of this form.
Please type or print.
Ms.
Mr.
_______________________________________________________________________________________________________________________
Legal Name
First
Middle
Last (Family)
_______________________________________________________________________________________________________________________
Home Address
Number and Street
City
State
Zip
(Country)
Senior Year
First Semester
Second Semester
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
In accordance with the Federal Family Educational Rights and Privacy Act of 1974, matriculating students have access to their application les.
The act further provides that you may waive your right to see your evaluation. Please indicate your preference by checking the appropriate box.
I waive or
I do not waive my right of access to this evaluation.
Signature ____________________________________________________________________________
Date ____________________________
TO THE GUIDANCE COUNSELOR OR COLLEGE ADVISER
Please ll in the information below and complete the back of this form in reference to the student listed above.
Date ___________________________
Name (please print)_____________________________________________________________________
Signature _____________________________________________________________________________
Position ______________________________________________________________________________
School name __________________________________________________________________________
Address ______________________________________________________________________________
Number and Street
City
State
Zip
Telephone ____________________________________________________________________________
Area Code
Number
FAX number (if available) ________________________________________________________________
Electronic mail address (if available) _______________________________________________________
OVER PLEASE
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Parent category: Education