Senior Autobiography Autobiographical Information: NAME: DATE OF BIRTH: ADDRESS: CELL NUMBER: EMAIL ADDRESS: Living with: Father: ___ Mother: ___ Stepfather: ___ Stepmother: ___ Other: ___ SIBLINGS: Name: ______________________________________ Age: _____ School:_________________ Name: ______________________________________ Age: _____ School:_________________ Name: ______________________________________ Age: _____ School:_________________ Name: ______________________________________ Age: _____ School:_________________ --------------------------------------------------------------------------------------------------------------------------------------

Parental Information: Father’s Full Name:

Mother’s Full Name:

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Is he living? __________________________________

Is she living? __________________________________

Home address: (only if different from yours)

Home address: (only if different from yours)

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______________________________________________

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Occupation: __________________________________

Occupation: __________________________________

Employer: ____________________________________

Employer: ____________________________________

Name of College attended: (if any)

Name of College attended: (if any)

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Degree: ____________________ Year: ___________

Degree: ____________________ Year: ___________

Name of Professional or Graduate School: (if any)

Name of Professional or Graduate School: (if any)

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Degree: ____________________ Year: __________

Degree: ____________________ Year: __________

What (if any) foreign languages are spoken in the home? __________________________________________ Did you learn this language before English? _____________________________________________________

Tell me about yourself List at least three of your most distinguishing or most admirable qualities from the list below. Explain further using the space below. Academic motivation

Sense of humor

Academic creativity

Concern for others

Academic self discipline

Energy

Academic growth potential

Emotional maturity

Leadership

Personal initiative

Self confidence

Reaction to setbacks

Warmth of personality

Respect accorded by faculty

Explain:

How would people who know you well describe you? Do you agree with their assessment?

The things about yourself that you would most like to improve, develop or change are: And why?

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What has been the most stimulating intellectual experience you have had outside of the classroom? (For example: summer experiences, travel, work) Please explain in detail.

Describe circumstances which may have affected (positively or negatively) your personal or academic growth or progress (for example: an extended illness, a specific situation within your family or with a teacher, etc.). How are you different as a result?

What book has had the greatest impact on you and why?

Who has had the greatest impact on you and why?

What kind of environment enables you to learn best?

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In or out of school, please list any awards and/or honors you have received.

Describe the academic experience or accomplishment (major paper, science experiment, artistic project) of which you are most proud. Explain why you take pride in it.

What major (if any) and career goals are you thinking about right now?

Please list the colleges/universities you are considering at this time.

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EXTRACURRICULAR ACTIVITIES A. PARTICIPATION IN SCHOOL ACTIVITIES Extracurricular Activity

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Leadership positions held/awards

B. PARTICIPATION IN NON-SCHOOL ACTIVITIES (Summer Experiences, community service, etc.)> Community Activities/Service

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Describe Involvement

Which activity was most important to you? Why?

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C.

WORK EXPERIENCE

Job

Dates of Employment

Place of Employment

Job Responsibilities

D. SPECIAL INTERESTS/TALENTS OR HOBBIES

E. TRAVEL

YEAR

(If you have traveled or lived in different localities, comment on those significant experiences).

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Transcript Explanation Worksheet Please review your enclosed transcript. Do you believe your high school grades reflect your ability? If not, what circumstances have prevented you from reaching your full potential? List below any grades you wish to explain that appear on your transcript. Give a clear explanation about why you received the grade and how the grade does not reflect your ability. NAME OF STUDENT: _______________________________________________________________________

Course: __________________________________ Final Grade: _________ School Year: _________ Explanation:

Course: __________________________________ Final Grade: _________ School Year: _________ Explanation:

Course: __________________________________ Final Grade: _________ School Year: _________ Explanation:

Are there any courses that you could not take, but wanted to due to scheduling conflicts?

PARENT BRAG SHEET

Parental input is often very useful to the counselor when writing the letter of recommendation. Please answer the following questions. NAME OF STUDENT ____________________________________________________________ 1) What five to six-adjectives would you use to describe your senior student?

2) Please describe your child in terms of achievement in high school. What example would you use to describe your child at his or her best in the school setting?

3) Please describe your child as a person. What qualities do you most admire? What anecdote might illustrate your child at his or her best?

4) Have there been any unusual personal circumstances that have affected your child’s educational experiences or personal development? Please explain.

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