Horace Greeley High School
70 Roaring Brook Road
Chappaqua, NY 10514
Student Counselor –
SENIOR AUTOBIOGRAPHICAL RECORD
Colleges want to know more about their applicants than the numbers on a transcript reveal. This
autobiographical record allows you to share with us those areas that distinguish you from other
students. We believe gathering and reviewing this information may help you as you complete your
college applications.
This Senior Autobiographical Record includes four parts:
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a 12th grade college/counselor questionnaire.
a personal statement
a parent’s essay
a copy of your rights and responsibilities in the college admissions process.
We hope you will spend some time with this. Your reflections and thoughts here help us to assist you
in your process.
Email the completed Autobiographical Record to your counselor ASAP.
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12TH GRADE COLLEGE COUNSELOR QUESTIONNAIRE
Full Legal Name Social Security Number Citizenship (If not U.S.) Type of Visa Language spoken at home -
FAMILY EDUCATIONAL BACKGROUND
FATHER -
MOTHER -
College/University -
College/University -
Degree(s) -
Degree(s) -
Current Occupation -
Current Occupation -
Employer -
Employer -
FUTURE PLANS
Tell us something about your current plans for next year - what colleges you have visited or plan to visit, to
which schools you plan to and if you intend to apply Early Decision (ED) or Early Action (EA). If your plans
are unclear, tell us.
List below fields of study and/or courses you might like to take in college:
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Are you satisfied with your academic performance in high school?
If not, what circumstances have prevented you from doing your best?
How have you spent the each of the three past summers?
9th
10th
llth
EXTRACURRICULAR AND ACTIVITIES
Some of you completed a junior autobiography and listed activities and leadership positions as well as
volunteer activities. If you did that please just add any new activities or leadership positions. If you did not,
please list all activities in which you participated by grade.
12th Grade
11th Grade
10th Grade
9th Grade
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Your Personal Statement
When you apply to college, most of you will be asked to write essays to be included as part of your application.
In the space below or on a separate sheet of paper, we’d like you to write an essay for your counselor. You may
want to think of this as practice for the real thing since what you write here may become the core or foundation
for the essays you send to colleges.
Colleges want to understand who you are as a person and student and what makes you different from others.
Your essay is an opportunity to tell them who you are in your own words.
You may choose a variety of ways to approach this - describing your unique characteristics, telling about an
unusual experience, talking about talents or skills, describing intellectual or academic interests, revealing
issues that you feel passionately about, etc. Avoid simply writing a narrative list of your activities.
We understand that writing about yourself can be more difficult than talking about yourself. No one will see
your work except your counselor and anyone else you choose to share it with. It doesn’t have to be perfect.
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Parent’s Statement
Parents can play an important role in the college process. Your support, written comments, and insights are
appreciated by the counselor.
Take some time to tell us more about your son/daughter. In particular, we are interested in how you view your
son or daughter as a learner and as a person.
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