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Qohs Secondary School Report Form

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QUINCE ORCHARD HIGH SCHOOL

15800 Quince Orchard Road, Gaithersburg, MD 20878

301-840-4650

QOHS SECONDARY SCHOOL REPORT FORM

Instructions:

Students should complete Section I and submit the form to their school counselor.

Counselors should

complete Sections II and III and forward this form, along with the respective admission application, to each school to which

the student is applying.

Section I

Student Name ______________________________________________

S.S. Number _______-______-_______

Last

First

Address __________________________________________________________________________________________

Street

Apt. No.

City

State

Zip

E-mail Address ____________________________________________________________________________________

I am applying for :

( ) Early Decision

( ) Early Action

( ) Regular Decision

( ) Other ______________________

I recognize the confidential nature of this document and I ( ) do

( ) do not waive my right to access.

Student’s Signature ____________________________________________________

Date _____________________

Section II

High School Quince Orchard High School

High School CEEB 210564

Address 15800 Quince Orchard Road, Gaithersburg, MD 20878

Phone 301-840-4650

Fax 301-840-4767

Counselor’s Name

_____________________________________________

Title ____________________________

Percentage of seniors attending: Four-Year __________

Two-Year __________ institutions.

Grading scale

(X) 4.0

( ) 100

( ) Other ______________________________

Passing Grade is D

Student’s GPA: ( ) Weighted _________

( ) Unweighted __________

GPA includes (check all that apply): (X) 9

Grade (X) 10

Grade (X) 11

Grade ( ) 12

Grade (X) We do not rank

See Profile for grade distribution

Is the student’s course selection: ( ) Most Demanding

( ) Demanding

( ) Average

( ) Below Average

Is the academic record of this student an accurate indication of the student’s ability?

( ) Yes ( ) No. If no,

please describe the circumstances.

_________________________________________________________________________________________________

SENIOR YEAR COURSES: See attached transcript

Section III

Please comment on the following items. (A recommendation letter may replace this section.)

Academic Ability/Personal Character/Counselor Statement: See attached letter

How long have you known the applicant? ________

I recommend this student: ( ) With reservation

( ) Fairly strongly

( ) Strongly

( ) Enthusiastically

Counselor’s Signature __________________________________________________

Qohs Secondary School Report Form

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