DELHI PUBLIC SCHOOL, GURGAON

CIR/88/P/2022-23
25th May’22

Dear Parents,

Many of our students apply abroad for under graduate programmes. You are aware the application
process for overseas admission and few Indian universities require letters of recommendation,
transcript and predicted scores. For the required support from school, please note the following:

 The attached form comprises of four parts.

 Part 1: Details for School LOR: It is mandatory for all students to fill this part.
 Part 2: Requisition Form for Documents
 Part 3: All About Me – form for Counsellor Recommendation
Part 2 and 3 are to be filled by those students who would be applying to various universities
which require the supporting documents from school.
Students who are sure that they do not intend to apply to such universities should strike off the
form and write NOT APPLICABLE.
 Part 4: Form for Teacher Recommendation: to be submitted at least 20 days before the first
application due to the respective subject teachers with whom the subject LOR request has
been placed in Part 2.
 Deadlines for applying at various universities may differ, however, the closing date for students
to submit this duly filled form (Part 1, 2 & 3 together) is 31st July 2022. You are requested to
kindly adhere to the specified date.
 For any queries, please contact the School Counsellor, Ms. Anamika Sethi at
counsellor@dpsgurgaon.org

We wish our children all the best in their future endeavours.

Anamika Sethi Arpna Gupta Aditi Misra

High School Counsellor Vice Principal Director Principal

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 Part 1 - Details for School LOR (Class XII)
(Please Fill the Form in Block Letters)

Name: ______________________Gender:_____ Class /Section: _______Date of Birth: ____________

Reg. No. ______ Mother’s Name: ___________________ Father’s Name: ____________________
Academic achievements:
Scholar Badge Blue Blazer Blue Badge I Blue Badge II Blue Tie Gold
Medal
Name of the Olympiad
1. ______________________________ International / National Rank _________Year _______

2. ______________________________ International / National Rank _________Year _______

SMTE - 2 NTSE NSTSE Rank ________ Year_______

Proficiency:
Subject __________________ Class __________
Music Class __________ Art Class __________
Dance Class __________ Sports (Name) Class __________
Dramatics Class __________ Community Service Class __________
Photography Class __________ MUN Class __________

Leadership Post:
Class XI: _________________________________ Class XII: _________________________________
MUN Achievements (only through school):
Inter School MUN: Year _________ UMUN: Year __________ IUMUN: Year __________
Awards (If any):________________________________________________________
Clubs
Node Class _____ Allotropes Class _____ Red Shift Class _____
SQUAD Class _____ Pulse Class _____ View Finders Class _____
Pi Pi Squad Class _____ Dharohar Class _____ Yuvrang Class _____
As you Like it Class _____ Kaizen Class _____ Insight Class _____
Ensemble Class ____ Lingua Clava Class _____ LLC Class _____
TedEx Youth Class ____

Peer Education
Class IX Class X Class XI Class XII

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Founder’s Day Production Participation (Online): Yes/ No
Specify (if yes) _________________

Theatre Achievements
Inter School Class __________ Event & Position_________________________________

Intra School Class __________ Event & Position_________________________________

Music Achievements
Inter School Class __________ Event & Position_________________________________

Intra School Class __________ Event & Position_________________________________

Dance Achievements

Inter School Class __________ Event & Position_________________________________

Intra School Class __________ Event & Position_________________________________

Sports Achievements

International Class ____Rank___ Name of Sport & Tournament_________________________

National Class _____Rank____ Name of Sport & Tournament _________________________
State Class _____Rank____ Name of Sport & Tournament _________________________
District Class _____Rank____ Name of Sport & Tournament _________________________
Inter School Class ____Rank__ Name of Sport & Tournament _______________________
Intra School Class ____Rank____Name of Sport & Tournament _________________________
(Annual Sports Meet)

Community Service
Shiksha Kendra Class ______ Team Shiksha Kendra Class ______
Interact Club Class ______ CanKids Class ______
Project Muskan Class ______ Cancer Awareness Campaign Class ______
Duke of Edinburgh International Award Gold Silver Bronze
Girl Up Class ______

Online participation/ Achievement during Class XI/ XII

Inter School Class __________ Event & Position_________________________________

Intra School Class __________ Event & Position_________________________________

Any Other Achievement through school:

________________________________________________________
________________________________________________________

All achievements have been verified by the Class Teacher Signature _____________________

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 Part 2 - Requisition form for documents required to apply to
International and few Indian Universities

Name _________________________________ Class and Section ____________

Documents’ request placed on ______________ First Application Deadline: __________

Countries applying to ___________________________

Please tick against the required documents:

1. Letter of Recommendation

Counsellor

Class Teacher / Subject Teachers (teaching classes XI and XII only)

Please specify: a) _________________________

b) _________________________

2. Transcript

3. Predicted Score

4. Mid-Year Report of Pre-Board I / II

5. School Profile for _________________________University

Kindly submit the photo copy of mark sheets of classes IX, X and XI along with this form.

Kindly note:
 This duly filled form will be processed on approval by the Principal.
 School will require fifteen working days to process your request.
 Letter of recommendation will be uploaded directly by the counsellor and concerned
teachers. Hardcopy of the same will not be given to the students.
 Transcript, Predicted score and Mid-Year report should be scanned and mailed to School
Counsellor, Ms. Anamika Sethi (counsellor@dpsgurgaon.org) in pdf format. Seven
working days will be required by her to upload the documents. Please ensure that the size
of each file is less than 500 KB.

Parent’s Signature __________________ Contact No_________________

Remarks by the Director Principal ___________________

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 Part 3 - All About Me- Form for Counsellor Recommendation

The school counselling and guidance services would like you to share information that can help shape
and personalize your letters of recommendations required for international universities and a few Indian
universities. Please answer all the questions carefully and thoroughly.

Student Name: _____________________________ Class & Section: __________

Standardized test Scores: SAT/ AP: First Application Deadline:

1. The three words that best describe me (with examples to support):

2. An accomplishment at school that I am proud of (organizing events, a project, learning a

difficult concept, working collaboratively or anything else)

3. A personal accomplishment I am most proud of (with reason):

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4. My greatest personal strengths are:

5. My hobbies/What I am passionate about & how I have pursued my interests:

6. Here is a list of attributes universities consider when reading your application. Select 1 or 2 of
these attributes and share an example when you demonstrated these traits in School.
Independence, academic achievement, initiative, disciplined work habits, creative thinking,
critical thinking, response to setbacks, maturity, motivation, intellectual curiosity, confidence,
integrity, concern for others and leadership.

7. Two subjects which interest me the most and why:

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 8. Internships I have done along with the specific nature of work: (certificates to be attached)

9. My career and personal goals are:

10. What do you plan to study in university and why?

11. My journey during the session (2022 – 23) so far. How has pandemic impacted my life?

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 Part 4 – All About Me- Form for Teacher Recommendation

Introspect, reflect, and spend time on this form and provide comprehensive and relevant details to help
your teacher craft a recommendation that shows who you are as a person. Make sure that the
information is relevant to what you want to do and will help you get into your target university. Share
specific details with both subject teachers (with whom the subject LOR request has been placed in Part
2) so that LOR stands out and there is no repetition of content. This form is to be mailed to your
teacher at least 20 days before the first application is due.

Student Name: _____________________________ Class & Section: __________

Standardized test Scores: SAT/ AP: First Application Deadline: _________

From: Ms/Mr.__________. Subject: __________

1. What do you plan to study in university and why?

2. What are your future personal and academic goals?

3. Do your marks accurately reflect your academic ability and accomplishments?

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4. What strengths have you demonstrated in my classroom?

5. Here is a list of attributes universities consider when reading your application. Select 1 or
2 of these attributes and share an example when you demonstrated these traits in my class.
Independence, academic achievement, initiative, disciplined work habits, creative
thinking, critical thinking, response to setbacks, maturity, motivation, intellectual
curiosity, confidence, integrity, concern for others and leadership.

6. Describe a particular challenge you faced in my classroom and how you overcame it /
something you struggled with and then figured out/ any ‘wow’ moment with a concept.

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7. Describe a topic that you enjoyed or any academic accomplishment (project/ AIL etc) in
my class that you are proud of and why/ Which academic assignments make you thrive?

8. How has the pandemic impacted your academics in my class?

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