This form should be completed by a school counselor and submitted with an official high school transcript and copies of all SAT I or ACT score reports available for the applicant. The student should provide the information in the “Applicant” section and give the form to the school counselor completing the form. The counselor should return the form to the student, along with an official transcript and copies of exam score reports, in a sealed envelope.
Has the applicant ever been found responsible for a disciplinary violation at your school from 9th grade forward, whether related to academic or behavioral misconduct that resulted in probation, suspension, removal or expulsion from your institution?
To your knowledge, has the applicant ever been convicted of a misdemeanor, felony, or other crime, or have a court case pending against him or her at this time?
If you answered yes to either or both questions, please give the approximate date of each incident and explain the circumstances in the space below.
This recommendation must come from a teacher who has taught you an academic subject (for example, English, foreign language, math, science, or social studies). Print your name below and give the form to the recommender. Inform your recommender you are applying for admission to Union University and/or CBU. That person should return the form to you in a sealed envelope for you to submit with your completed application.
I WAIVE my right to access this form in the future and I understand I will never be able to see its contents.
I DO NOT WAIVE my right to access this form in the future and I may someday choose to see it once I enroll in college.
The student named above is applying for the Excel Leadership and Scholarship Initiative and admission to Union University and/or CBU. Excel is a Christian urban leadership development and scholarship initiative with a four-part strategy: (1) Locally recruits and selects a diverse, multicultural cadre of Memphis’ most promising urban student leaders; (2) Intensively trains this group of students in the months prior to college, equipping them to support each other, grow in leadership, succeed academically, and grow as service-minded leaders and agents of transformation; (3) Helps facilitate the Excel scholarship and send the teams to Union University in Jackson, or CBU in Memphis for four years of Christian education at a highly diverse liberal arts college; and (4) Provides strong campus support and ongoing leadership development experiences to nurture these young people as they find their vocation and grow into the next generation of community leaders.
We are seeking young people who are passionate about learning, eager to foster intercultural communication and relationships, willing to step out of their comfort zones, committed to serving those around them, and ready to make a difference on the college campus and in their communities at home. The selection process also places high value on students' teamwork, critical thinking, and communication skills, as well as on their academic potential. In seeking to identify qualified students for this extraordinary opportunity, we value your candid evaluation of the applicant.
How long have you known the applicant and in what context?
List the academic courses that you have taught this student, noting for each the applicant’s year in school (10th, 11th, 12th, etc.) and the level of course difficulty (AP, honors, IB, elective, etc.). If you have not taught the student an academic subject, do not complete this form (the student could still ask you to complete the community recommendation instead).
What are the first words that come to your mind to describe the applicant?
Compared to other college bound students you have worked with, how would you rate this student in terms of:
Please return both pages of this form to the applicant in a sealed envelope so that s/he can mail it by the January 16, 2015 application deadline. If you choose, you may include a recommendation letter as well.
May we contact you with information about Excel in the future?