High School Information Form

High School Information Form
This information is essential in evaluating the applicant.
Please answer each question as completely as possible.
To be completed by the student.
Applicant Information
Last name:_______________________________ First:_____________________ Middle:_______________
Date of birth (month/date/year):__________________________________
Important privacy note
By signing this form, I authorize all schools that I have attended to release all requested records covered under the Family
Educational Rights and Privacy Act (FERPA) so that my application may be reviewed by Ohio State. I further authorize the
admission officers reviewing my application to contact officials at my current and former schools should they have questions
about the school forms submitted on my behalf. I understand that under the terms of the FERPA, after I enroll I will have access
to this form and all other recommendations and supporting documents submitted by me and on my behalf, unless I waive my
right to access, below.
 Yes, I do waive my right to access, and I understand I will never see this form or any other recommendations submitted by me or on my behalf.
 No, I do not waive my right to access, and I may someday choose to see this form or any other recommendations or supporting documents submitted by me or on my behalf to Ohio State.
Student signature: _____________________________________________________ Date: ______________ To be completed by high school principal or counselor.
High school information
Please attach a copy of the applicant’s high school transcript.
Student State ID (SSID): ________________________
High school name:____________________________________________ CEEB code:_____________________
High school type:
 Public
 Non-public
 Home school
If public: This student has filed a letter of intent to participate in College Credit Plus and is approved for funding.
If non-public or home school: This student will apply for College Credit Plus funding through the state of Ohio.  Yes  No
 Yes  No
The applicant’s high school rank is: ____________ in a total class of ____________ (Approximate if necessary.)
Weighted GPA: ____________ on a ____________ scale
Unweighted GPA: ____________ on a ____________ scale
Is the applicant enrolled in a college preparatory curriculum?
 Yes
 No
In comparison with other college prep students at your school, please rank the applicant’s course selection:
 Most demanding
 Very demanding
 Demanding
 Average
 Below average
 Prefer not to comment
List the units in each academic area that the applicant needs to complete to meet high school graduation requirements.
Attach additional pages if more space is required.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________ Standardized test scores
Please list actual scores rather than percentiles.
ACT
SAT
Composite
score
English
PLAN
Critical
Reading
PSAT
Composite
score
Math
Critical
Reading
English
Math
Math
Reading
Reading
Science
Science
Math
Writing
Rating
Please rate this student on the following scale:
Maturity
Motivation
Academic ability
poor
below average
average
above average
exceptional
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Recommendation
What are the student’s goals for participating? Describe the student’s personal characteristics, including work habits,
intellectual ability, persistence and ability to balance multiple commitments. These additional comments are an important
part of the holistic review for the Columbus campus and are used when helping students select appropriate course work.
Attach additional pages if more space is required.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
I have fully advised this student and his/her parent(s) or legal guardian(s) of the available options and ramifications involved
in the College Credit Plus program.
Signature of person filling out form: ________________________________________ Date: ______________ Printed name of person filling out form: _________________________________________________________
Title: __________________________________________________ Phone: __________________________
Return this form to the applicant or submit it directly to Undergraduate Admissions, The Ohio State University, 281 W. Lane Ave., Columbus, OH 43210-1390.
UAP150135
Email address:____________________________________________________________________________