2017 ONLINE APPLICATION SCHOOL COUNSELOR FORM

THE STATE UNIVERSITY OF NEW YORK
2017 ONLINE APPLICATION
SCHOOL COUNSELOR FORM
Application Services Center (ASC)
P.O. Box 22007
Albany, New York 12201-2007
FRESHMAN APPLICANTS ONLY
Please complete the Student Section of this form and submit it to your school counselor.
Student Section
Applicant ID Number:
U.S. Social Security Number:
Name:
-
-
/
/
First
Last
Middle
Address:
Street/P.O. Box
State/Province
City
Phone Number
area code):
(includingNumber:
Phone
My Applications:
Apt #
Zip/Postal Code
Country
Date of Birth:
Campus:
Curriculum:
Early Action/Early Decision:
[
[
] Yes
[
] No
[
] Yes
[
] No
[
] Yes
[
] No
[
] Yes
[
] No
] I have applied for Educational Opportunity Program (EOP) consideration.
I understand that my application cannot be processed if it has not been completed according to the instructions and that any knowing falsification or
omission of data may result in denial of admission or dismissal. All information submitted is therefore true to the best of my knowledge. If I am an Early
Decision/Early Action applicant, I agree to comply with the program requirements outlined in the Viewbook and Online Application Instructions. With my
signature, I authorize the release of my transcript(s) and standardized test scores to State University campuses for admission purposes.
Student Signature:
Date:
Required
Parent/Guardian Signature:
Date:
Required for Early Decision Applicants only
Counselor Section
This form, when complete, should be submitted to the Application Services Center (see address above). If you prefer, you can submit the
information on this form online by accessing your CounselorConnect account.
CLASS RANK AND GPA:
Please complete one of the following statements (a or b) about this applicant’s rank in class. If your school does not calculate or disclose exact
rank in class, we would appreciate your estimating this student’s rank as nearly as possible.
a This applicant currently ranks
in a class size of
.
This rank is:
b We do not calculate or disclose exact rank. I estimate this applicant’s position to be within the top
High School Average (at time of application)
High School Average:
on a scale of
.
✕ Weighted ✕ Unweighted (mark only one)
percent of his or her class.
✕ Weighted ✕ Unweighted (mark only one)
High School:
Official’s Printed Name:
CEEB Code:
Official’s Signature:
Date:
INSTRUCTIONS FOR SUBMISSION OF TRANSCRIPTS
Academic records must be submitted to each SUNY campus listed above.
• Counselors may upload high school transcripts for students who have applied through applySUNY to the Application Services Center at
www.suny.edu/counselor.
• Counselors may send high school transcripts by postal mail to the admissions office at each campus.
Questions? Call the Recruitment Response Center at 1.800.342.3811, Monday–Friday, between 8:30 a.m. and 4:30 p.m. (EST).
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