Campo Verde High School

College/Scholarship Recommendation Form

Name:Click here to enter text.

Email Address:Click here to enter text.

Cell Number:Click here to enter text.

☐Check here if you will be submitting or have submitted a Common Application.

Complete this form and make an appointment to submit it to you recommender(s).

☐Check here if you are a first generation college student (this means neither parent has a college degree).

  1. FAMILY

Relation / Name / Highest Degree Earned
4 year Bachelor / Master’s / Doctorate
Mother / Click here to enter text. / ☐ / ☐ / ☒ /
Father / Click here to enter text. / ☐ / ☐ / ☐ /
Sibling / Click here to enter text. / ☐ / ☐ / ☐ /
Sibling / Click here to enter text. / ☐ / ☐ / ☐ /
Sibling / Click here to enter text. / ☐ / ☐ / ☐ /
Sibling / Click here to enter text. / ☐ / ☐ / ☐ /
  1. COLLEGE/CAREER GOALS AND ACADEMIC INTEREST

(1)Is there a college to which you are applying that holds a special tradition in your family’s history?

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(2)Please list all colleges to which you are applying that require a counselor letter of recommendation.

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(3)Please list all colleges to which you are applying that do not require a counselor letter of recommendation.

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(4)What major/area of study are you considering for college? Why?

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(5)What career(s) are you considering pursuing? Why?

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(6)Do you feel that your transcript accurately reflects your academic ability? If no, explain what factors/circumstances have interfered with your academic performance?

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(7)What do you think are your academic strengths?

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List three faculty or staff members who could give you a positive appraisal.

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  1. CVHS ACTIVITIES

Activity Involvement / Check years participated / Description
9 / 10 / 11 / 12
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
  1. COMMUNITY/NON-CVHS ACTIVITES (Religious organizations, summer programs, volunteer work, etc)

Activity Involvement / Check years participated / Description
9 / 10 / 11 / 12
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
Activity / ☐ / ☐ / ☐ / ☐ / Click here to enter text. /
  1. WORK EXPERIENCE

Employer / Position / Hours per week / Dates of Employment
Click here to enter text. / Click here to enter text. / hours / Click here to enter text.
Click here to enter text. / Click here to enter text. / hours / Click here to enter text.
Click here to enter text. / Click here to enter text. / hours / Click here to enter text.
  1. PERSONAL

(1)Who are your personal heroes, men and women you admire, and why?

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(2)What special interests or hobbies do you pursue outside of school?

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(3)What personal experience, summer experience, school/work experience, or travel has been of significant importance to you and why?

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(4)Is there any information you would like for me to emphasize in my recommendation to help the colleges/scholarship committee make a more accurate appraisal of your application?

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(5)Describe (if any) family hardships or personal struggles in your lifetime (ex: death, job loss, illness, etc)

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  1. SELF-EVALUATION

Read the statements and rate yourself using the scale below.

Ratings / Below Avg / Average / Good / Excellent / Outstanding
Ability to organize/use time / ☐ / ☐ / ☐ / ☐ / ☐ /
Self-confidence / ☐ / ☐ / ☐ / ☐ / ☐ /
Desire to learn new things / ☐ / ☐ / ☐ / ☐ / ☐ /
Willingness to take risks / ☐ / ☐ / ☐ / ☐ / ☐ /
Ability to get along with others / ☐ / ☐ / ☐ / ☐ / ☐ /
Willingness to work hard / ☐ / ☐ / ☐ / ☐ / ☐ /
Imagination/creativity / ☐ / ☐ / ☐ / ☐ / ☐ /
Ability to express self / ☐ / ☐ / ☐ / ☐ / ☐ /
Sense of humor / ☐ / ☐ / ☐ / ☐ / ☐ /
Concern for others / ☐ / ☐ / ☐ / ☐ / ☐ /
Emotional maturity / ☐ / ☐ / ☐ / ☐ / ☐ /
Reaction to setbacks / ☐ / ☐ / ☐ / ☐ / ☐ /
Understanding new concepts / ☐ / ☐ / ☐ / ☐ / ☐ /
Self-discipline / ☐ / ☐ / ☐ / ☐ / ☐ /
Growth potential / ☐ / ☐ / ☐ / ☐ / ☐ /
Leadership / ☐ / ☐ / ☐ / ☐ / ☐ /
Energy / ☐ / ☐ / ☐ / ☐ / ☐ /
Motivation / ☐ / ☐ / ☐ / ☐ / ☐ /
Warmth of personality / ☐ / ☐ / ☐ / ☐ / ☐ /
Personal initiative / ☐ / ☐ / ☐ / ☐ / ☐ /
Respect accorded to faculty / ☐ / ☐ / ☐ / ☐ / ☐ /

Please write a paragraph about yourself utilizing words most descriptive of you. If you have already written a personal essay, you may elect to submit that in lieu of this.

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