Note: Type, fill out completely, and print. DO NOT USE PENCIL. Turn in this packet to Mrs. Lantos by
June 1st. If you have a significant summer experience, please give your counselor an addendum to this
packet in September.
Winston Churchill High School College Packet
Name: __________________________________ Nickname: ____________
Student ID #: _____________________ Counselor: ____________________
Student’s email: _____________________ Cell Phone #: _________________
Grade you entered Churchill: ____________
Other High Schools attended: ______________________________________
Did either parent/guardian graduate from college?
Parent/Guardian 1 ____yes _____no
if yes – Name of College _________________________________
Parent/Guardian 2 ____yes _____no
if yes – Name of College _________________________________
Are you a first generation college student? ______ yes ______ no
What language is spoken in your home? _______________________________
Are you fluent in any foreign languages?
Is so, please list them ________________________________________
Parent’s Thoughts
To help your senior’s school counselor compose his/her letter of recommendation, please write
information below that you think is important for your child’s counselor to be aware of. Consider personal
attributes or experiences that your child has had that the counselor may not be aware of. Feel free to
include specific examples. Bragging is always welcomed
(Attach and extra sheet if necessary)
Senior – your thoughts about yourself
Please take the time to answer the following questions thoroughly and thoughtfully. Write in
complete sentences, where appropriate. DO NOT SKIP ANY QUESTIONS. Your counselor will use
this information to write your letter of recommendation. If you need more space, please attach
additional paper.
1. Describe what you believe are your academic strengths. (for example, creative problem solving
skills, organization, etc,)
2. What courses have you enjoyed the most? Why?
3. Is your academic record an accurate measure of your ability? Why or why not? Have you had
any health, family or personal problems which may have affected your school performance that
you would like your counselor to share with colleges?
4. What are you interested in studying in college? Why?
5. Describe three of your positive qualities. Give examples of how you demonstrate each one.
6. List any talents, awards or honors (sports, music, academic, leadership positions) received.
7. Work Experience – list any jobs (including summer employment) you have held during the past
three years.
Employer
Dates of employment
# of hrs/ week
Specific duties and responsibilities
8. Approximately how many SSL hours have you earned? _____ Discuss the most significant
activity and why.
9. Discuss an extracurricular, personal or work experience that had the most meaning for you and
WHY?
10. Tell me something about yourself that I do not know. What sets you apart from other students?
11. Extracurricular and personal Activities – list all extracurricular, community, and family
activities and hobbies in the order of their interest to you. Include specific events and/or major
accomplishments such as musical instrument played, varsity letters earned, summer programs
attended, etc, etc. (chart on next page)
O/S (outside school/ in school)
ACTIVITY
9th
10th
11th 12th
GIVE DETAILS
describe activity, level of involvement,
hrs/wk wks/yr positions held, honors, awards, etc