Counselor Verification Form

Counselor Verification Form
Student's Name

First NameLast Name
Cumulative GPA (unweighted) blanks
Cumulative GPA (weighted)blank
Number of AP courses completed and/or currently enrolled blanks
Number of honors courses completed and/or currently enrolled blanks
Enrolled in an IB program

YesNo
Dual Enrollment Student

YesNo
Number of dual enrollment courses blanks GPA blank
Class rank blanks
First Generation College Student (parents/guardians did not attend college)

YesNo
Counselor's Name

First NameLast Name
Counselor's Email
example@example.com
Counselor's Phone Number
Please enter a valid phone number.
Signature*
Should be Empty: