Secondary School Report - Form 2 - American Federation Of School Administrators

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AFSA 2017-2018 SCHOLARSHIP PROGRAM APPLICATION
1101 17th Street NW Suite 408, Washington, DC 20036
Phone (202)986-4209 Fax (202)986-4211 e-mail
SECONDARY SCHOOL REPORT – FORM 2
(Please PRINT or TYPE)
Applicant’s Name: ________________________________________________________________
Name of High School: ______________________________________________________________
In compliance with Family Educational Right and Privacy Act of 1974, I authorize my High School to
release a copy of my transcript and to complete the information requested below.
Signature of Applicant: ____________________________________ Date: _____________________
THIS EVALUATION TO BE COMPLETED BY YOUR PRINCIPAL OR GUIDANCE COUNSELOR
Evaluator’s Name: __________________________________ Title: __________________________
Number of Students Graduating this June: _______________ Teacher/Student Ratio: ____________
Please explain your school’s marking system:
Applicant’s Class Rank: __________________ Applicant’s Total SAT Score: ___________________
Is the applicant in an accelerated or honors program? (If yes, please describe)
List any off-campus or independent study programs applicant has participated in:
List extra-curricular activities that the applicant participates in:
PLEASE ENCLOSE AN OFFICIAL TRANSCRIPT WITH THIS FORM
Evaluator's E-mail Address: __________________________________________________________
Signature of Evaluator: ________________________________________ Date: ________________
Please return completed form postmarked by February 28, 2018 to:
th
AFSA Scholarship Committee, 1101 17
ST, NW, Ste. 408, Washington, DC 20036

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