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Counselor Rec Letter Survey for Mrs. Schloemer's Students (Last Names N-R)
In order for Mrs. Schloemer to write you a rec letter, you must fill out this survey. NOTE: The more details and specifics you can provide, the more material your counselor can use in your rec letter for the college of your dreams or that incredible scholarship. Please answer in complete sentences and check your spelling---you need to impress me! Mrs. Schloemer will not share the details of this survey with anyone unless there is a risk of harm.
Last Name
Your answer
First Name
Your answer
Student ID Number (lunch number)
Your answer
Student Cell Phone Number (in case I need to call you/text you about something regarding this survey)
Your answer
Student Email (in case I need to contact you to about something regarding this survey)
Your answer
School Activities: Please list all clubs/service orgs/activities/sports you have participated in and which year you did them. (ex. Football 9-12, Habitat 10, 12). If you did not participate in anything, please write none.
Your answer
Explain what you have gained from your participation in the activities you mentioned above so far (skills and/or experience).
Your answer
Have you received any awards or recognitions from your activities? If so, explain. If not, please write none.
Your answer
Please provide any information for any organizations/summer camps/internships/volunteer work you have participated in OUTSIDE of CHS. If none, write none.
Your answer
Please list & explain any leadership positions you have held at Campbell, in the community or work activities. If none, write none.
Your answer
What do you view as your single most important accomplishment in high school?
Your answer
What makes you unique
Your answer
What are your strengths?
Your answer
Tell me about a circumstance wehre you experienced failure. How did you deal with it, how did overcome it and/or how did it change you as a person?
Your answer
Who is your role model and why?
Your answer
List 3 words on how YOU would describe yourself.
Your answer
List 3 words on how a TEACHER would describe you.
Your answer
List all paying jobs you have or had. Why are you choosing to work while in high school? If none, write none.
Your answer
How would you describe yourself as a student?
Your answer
What do you feel are your biggest challenges pertaining to school?
Your answer
Have there been changes, positive or negative, or a particular situation that has occurred in your high school years that you feel has affected you, your grades or your participation in school? (Example: illness in family or self, divorce, summer experience, etc.) If none, write none.
Your answer
What major do you plan on pursuing in college and/or career later in life?
Your answer
How do you plan to pay for college? Are there outstanding circumstances (financially) that may make attending college difficult? (You don't have to explain in great detail if you don't want to but a little insight would be helpful).
Your answer
By signing electronically below, I understand that Ms. Schloemer may use any of the information I have provided in this survey to write my recommendation letter for only the sole purpose of writing a recommendation letter. I have provided accurate information to the best of my knowledge. If you agree with these terms, please sign your full legal name below. If you do not agree to these terms, please write DO NOT AGREE.
Your answer
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