Secondary School Report Form - Belmont University
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2B e l m o n t U n i v e r s i t y
Secondary School Report Form
This section to be completed by the applicant.
Applicant’s name ________________________________________ Date of Birth ___________________________________________
Address____________________________________________________________________________ Apt. #_____________________
City ________________________________ State ____________ Zip code ____________________ County ____________________
I hereby
my right of access to this document should I matriculate at Belmont University.
waive
do not waive
I I
I I
___________________________________________________________________________________________________________
Signature
Date
This form should be given to your high school counselor. (Home schooled students should have this form completed by someone other
To the applicant:
than a family member.) If you have been out of high school for more than five years, you may have someone who knows you better complete this form.
The above student has applied for admission to Belmont University. We appreciate your providing the information
To the person completing this form:
requested below. Please attach a high school profile, if available.
Class Rank _____________ of ______________. If class rank is not available, please place student in proper decile.
student rank
total class
Top __________ (10th, 20th, 30th). Please indicate any courses weighed in the computation of rank_____________________________________
_____________________________________________________________________________________________________________
How rigorous has this student’s academic program been relative to the opportunities available within your school?
Most rigorous
I I
Most rigorous in some areas, average or above average in others
I I
Average
I I
Below average
I I
Of the applicant’s class, approximately________% plan to attend college;________% a four-year college.
This student’s
grade point average on a 4.0 scale is _______________________________________________________________
cumulative
(mathematics, English, social science, science, and foreign language)
This student’s
grade point average on a 4.0 scale is
academic
_____________________________________________________________________________________________________________
to
School’s official grading scale:
= _________
_________
A
to
= _________
_________
B
to
= _________
_________
C
to
= _________
_________
D
to
= _________
_________
F
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