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NameThe form is designed as a fill-able Word doc form. If you encounter any problems
A typeDocumentation
Personal Profile

&

Request for a Letter of Reference

This document is intended to be a living document.

  1. Save it to your computer.

  2. Enter information.

  3. Return to the form to update or enter new information.

  4. Don’t let it sit.

  5. Don’t think that it is ever complete.

  6. Review the information.

  7. Improve the information.

The form is designed as a fill-able Word doc form. If you encounter any problems

with formatting your information, please let Mr. Pocock know what the problem is.


  1. Purpose of this Form:

    1. The purpose of this form is to gather information about you that can be helpful to you and to others in activities such as:

      1. Completing applications for scholarships, bursaries or financial aid packages;

      2. Providing information and reflection as the basis for a request for a reference letter;

      3. Writing a resume.

Date Requested:

Click here to enter a date. Use the ‘down’ arrow to open the calendar.




Date Required:

Click here to enter a date. Use the ‘down’ arrow to open the calendar




Student Name:

Preferred First

Legal First

Middle

Last



Name (exactly as on your application):

Click here to enter full name as on application




  1. Personal Information:




Address

Unit # and/or House #, Street, City, Postal Code

Date of Birth

Choose an item.

Choose an item.

Choose an item.

Grade

Current Grade

Student ID

Fraser Heights Student Number

Application Number

University Admission Number or Other Identifier

Canadian Citizen or Permanent Resident?

Yes ☐ No ☐




  1. Purpose of the Letter:

Scholarship ☐ College or University ☐ Employment ☐ Other (Describe Below) ☐

If ‘Other”, Indicate the Purpose of the Application



  1. What are you applying for? Be specific.

Click or tap here to enter text.

  1. Why are you attracted to this opportunity? How does it relate to your skills, interests, experiences, and goals?

Click or tap here to enter text.

  1. What specific academic, social, personal or other talents do you have that make you a suitable applicant for this opportunity? Be concise. Summarize your key points. You will be attaching your Student Profile Form.

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  1. What are your long-term goals?

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  1. What is the website address of the institution? This is the address where the referee can check the specific requirements that the application requires.

Click here to enter text.

  1. What are the key components of the mission statement of the institution?

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  1. Address Information for the University, Scholarship, etc. :

Name

Correct Full Legal Name of the Institution

Department

What is the Name of the Department that will be Handling the Application?

Institutional Address

Room #, Building, Street, etc. Be Complete

City

City

Province, State, Country

Province/State, Country (if applicable)Click here to enter text.

Postal or Zip Code

Postal or Zip Code




  1. Academic Information: Your Referee will normally need to comment on your academic performance and standing. Rather than listing the courses that you have taken and the grades that you received, indicate if you have any or all of the following and include them with this form. If you do not have any of these, please request a copy of an Unofficial Marks Printout from your counsellor.




  1. Transcript Yes ☐ No ☐

  2. Unofficial Marks Printout Yes ☐ No ☐

  3. Current Report Card Yes ☐ No ☐



  1. Academic Information – Pt 2: - Courses or Qualifications that will not be recorded on your transcript.

Name of Course

Qualification Obtained

Year Completed

Insert Course Name

Indicate Qualification Obtained

Enter Year Completed

Insert Course Name

Indicate Qualification Obtained

Enter year Completed

Insert Course Name

Indicate Qualification Obtained

Enter Year Completed



  1. Academic Information – Comments - Pt 3: What have you learned?

Comment on the courses that you have taken. Have they developed or increased your curiosity in any area/s? Have they motivated you to undertake other activities - whether you see a direct connection or not? What skills, attitudes, abilities or interests have you acquired through your studies? These are not items to respond to. They are examples to give you ideas from which to start your thinking. Add any other information that you consider of value. Enter your information in any form that you wish - point form, full sentence, flow chart, graphic, etc. In all cases, support your statements or information with examples, evidence or an explanation.

Enter your comments here.

  1. Awards or Other Recognition: List any awards or other forms of recognition that you have received during your years at FH or other schools during your secondary school years such as Honour Roll, Arts Awards, Department Awards, Exhibitions or Science Fairs, Sports, etc.

Name of Award

Description

Year Received

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click

Enter Award Name Here

What did the award recognize?

Click



  1. Awards and Other Recognition – Pt 2: Why did you receive the award/s? What made you different from others who could have received the award/s? Was it your commitment; teamwork and collaboration; skill or a natural talent for the subject of the award; or was it some other attribute that made you the best choice to be the recipient of the award?

Enter your comments here.

  1. Information Frequently Requested From the Referee:




Questions typically or frequently asked about the applicant to which the referee must respond.

  1. Indicate the nature of the information that you would wish for your Referee to consider including in the Letter.

  2. Indicate the evidence that supports that information. Be specific.

  3. Do not duplicate information in your Student Profile Form. Use “See

Student Profile Form” if the information is accurately found there.

Quality of Writing

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Creative Original Thought

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Class Discussion Contribution

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Motivation

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Reaction to Setbacks

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Concern for Others

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Five Words That Would Describe You, the Applicant

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Courses and other areas of contact with the Referee

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Academic Strength

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  1. School, Volunteer and Extra-curricular Involvement: List key organizations in which you have been involved inside and outside of FHSS such as Clubs, Scouts or Girl Guides, Duke of Edinburgh, Church Groups, Job’s Daughters, Service organizations, Humanitarian organizations, Church groups, Peer Tutoring, Reading Buddies, Sports Day, Food Bank, Red Cross, Run for the Cure, etc., etc.

Use a separate sheet if necessary or provide a list that you have already prepared in the form of a resume or other format.

Club/Group

Role

Length of Involvement

Hrs/week volunteering

Sponsor

Name of Group

Your function

Mos/Yrs Involved

Hrs/Week

Name

Name of Group

Your function

Mos/Yrs Involved

Hrs/Week

Name

Name of Group

Your function

Mos/Yrs Involved

Hrs/Week

Name

Name of Group

Your function

Mos/Yrs Involved

Hrs/Week

Name

Name of Group

Your function

Mos/Yrs Involved

Hrs/Week

Name

Name of Group

Your function

Mos/Yrs Involved

Hrs/Week

Name



  1. School, Volunteer and Extra-curricular Involvement – Comments - Pt 2: What changed?

Comment on how you changed or developed as a result of your involvement in the listed activities. Comment on specific changes such as your ability to work in a collaborative or co-operative manner, interpersonal skills, communication skills and abilities, planning and organization, understanding of or involvement in leadership activities, or whatever changed. These are not items to respond to.

How have you changed as a result of your involvement in volunteer activities? Why did you get involved? Has your involvement taken a specific direction? Do your volunteer activities contribute to your ideas of your goals? In general, how has your involvement been of value or important? In all cases, support your statements or information with examples, evidence or an explanation.

They are examples to give you ideas from which to start your thinking. In all cases, support your statements or information with examples, evidence or an explanation.

Enter your comments here.

  1. Initiative. Have you identified and met an “unmet” need in your community?

If you have identified an unmet need in your community and have taken the initiative to act on that need, provide details of, and your comments on, that action.

Enter your comments here.



  1. Sports Activities: List any activities in which you have been involved either as an athlete, referee, coach or in another capacity.

Activity

Role

Length of Time

Sponsor

Team Name

Your Function

Click

Name

Team Name

Your Function

Click

Name

Team Name

Your Function

Click

Name

Team Name

Your Function

Click

Name

Team Name

Your Function

Click

Name



  1. Sports Activities – Comments - Pt 2:

Identify areas in which you learned about or developed new skills in areas such as physical or mental wellness, teamwork, commitment, discipline, responsibility or in other areas and why those lessons were significant to you. These are not items to respond to. They are examples to give you ideas from which to start your thinking. In all cases, support your statements or information with examples, evidence or an explanation.

Enter your comments here.

  1. Previous Work Experience: List previous paid work that you have done around the school or in the community such as gardening, McDonalds, child-care, newspaper routes, etc. List your most recent job first. If you have completed the school’s Work Experience program, include that work placement but put (WEX) at the end of the employer’s name.

Employer

Responsibilities

Skills Developed

When

Employer’s Name

What was your function?

What did you learn?

Mos/Year

Employer’s Name

What was your function?

What did you learn?

Mos/Year

Employer’s Name

What was your function?

What did you learn?

Mos/Year



  1. Personal Interests: List any activities or interest in which you are involved in your spare time including such activities as hobbies, musical instruments played/practiced, poetry, writing, musical composition, woodworking, mechanics, etc.

Identify your activity, the nature of and length of your involvement, its importance to you, etc.

Identify your activity, the nature of and length of your involvement, its importance to you, etc.

Identify your activity, the nature of and length of your involvement, its importance to you, etc.

Identify your activity, the nature of and length of your involvement, its importance to you, etc.



  1. Personal Development: What are your plans, both in the short and long term, for your post-secondary education and work? What do you hope to achieve in the future? How?

Enter your comments here.

  1. Personal Development – Comments – Pt 2: Using the totality of your experience including your academic involvement, extracurricular activities and your personal interests, comment on:

  1. Your assessment of your creativity or innovation in thought or action; in academic or extracurricular activities; in artistic, musical, written or other, or any, form/s of activity.

Enter your comments here.

  1. Describe and support your assessment of your abilities as a leader and your involvement in leadership activities.

Enter your comments here.

  1. Describe and support your assessment of how your curiosity has developed or changed and how it is shown in your activities.

Enter your comments here.

  1. Describe and support your assessment of how your motivation has developed or changed and how it is shown in your activities.

Enter your comments here.


  1. Summary:

Using this information and any other information that is relevant to your development as a person, indicate how your academics and your activities have led to changes in you, your abilities, and your relationships with others. Your response should show self-reflection, what you have learned, how you learned it and how you have applied the changes that have occurred.

Click or tap here to enter text.



  1. Summary – Part 2.

The following question is one that is frequently included in various applications. What additional information would you provide to completely answer this question? Answer in point form.

Describe the quality of the student’s intellect and academic work. Please comment on the student’s originality of thought, ability to grasp difficult concepts, and willingness to take risks and go beyond the normal classroom experience. Please provide specific examples. The important part of this question is the provision of examples. Do not expect your teachers to remember the specifics of when you exceeded expectations. Provide information that identifies the course, the year and the nature of the work involved or the initiative that you took. (Maximum: 100 Words)

Click or tap here to enter text.



  1. Summary – Part 3.

Taking the information that is included in this material as a whole, what is the impression or image of you that you are hoping to convey to the recipient of the Letter of Reference?

In this part of the document, you should indicate any specific requirements that apply to the purpose of the requested letter. For example: The LORAN scholarship application has three basic criteria (Character, Service and Leadership) and you should specifically deal with those criteria to the extent that they are not fully covered in the earlier parts of this document.

The LORAN materials also include the following:

We are looking for young people who deeply value honesty, are curious by nature and are interested in a wide range of subjects. The scholars we select are willing to take meaningful risks and prioritize results over appearances. Each one has shown a sustained commitment to service in the community, has taken the initiative to create positive changes and is interested in working for a better world.”

Check for specific criteria that apply to the application that you are making and ensure that you deal with those criteria in your response to this item.

Click or tap here to enter text.

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