Name _______Leslin Ramos_________ Date __9/6/16___________________________ Period __4_

High School & Community Service Activities Record

Place an X for each corresponding grade you participated in the following school activities. Please be
extremely thorough in listing all activities.

9th
x
x
x
x

10th 11th 12th

x
x
x
x
x
x
x
x
x
x
x
x

9th

10th 11th 12th

x
x
x

Special Talents & Hobbies

Soccer

9th
x

10th 11th 12th

x

Athletics, Cheer, Dance, Theater, Band

Soccer Athlete
Churchs chorus

9th
x

10th 11th 12th

x
x

Awards, Honors, and Other Achievements

Math Student Roll Award
3.5 or up GPA Award

9th

10th 11th 12th

x
x
x

Jobs
Chefs assistant
Babysitter

9th

10th 11th 12th

x
x
x
x
x

Community Service (volunteer work)

Soccer Coach for 5th and 6th graders
Basketball Coach for 5th and 6th graders
Volleyball Coach for 5th and 6th graders
Football Coach for th and 6th graders

Hours

Organizations, Clubs, Activities & ASB (please note any leadership roles)

Medtech Academy

Name __________Leslin Ramos________________________ Date

_____________________________ Period __4_

High School & Community Service Activities Record (For University of California)
In addition to your courses and grades, we want to know about any honors youve received and how you spend your time
outside of school. Use this worksheet to prepare concise descriptions of your most significant awards and activities. You may
list up to five entries in each category, so think carefully about what you want to highlight. Also make sure to fully describe
each item (up to 160 characters) for admissions offices to best understand your involvement.
Coursework Other Than AG List the courses you took during high school, other than those
approved for UC admission, that demonstrate a particular focus or interest (e.g., language immersion
courses or nontransferable college courses).

Course Name

Description of Course

Computer and Design

Design work pages, learn how to edit videos,

photoshop an image

9th

preparation programs that are designed to help students prepare for university study. These programs may include
academic enrichment programs sponsored by colleges/universities, research programs and study-abroad programs.

Hours
Per
Week

12th

Organization

Description of organization and your responsibilities

Key Club

Feed the homeless, clean up beach, serv

Work Experience List paid work only.

Job Title

Responsibilities

Chefs assistant at
Cooking Camp

Supervise kids cooking, make

groceries, cut vegetables, place dishes
in dishwasher,
Supervise kids, cook for them, bathe
them, take them to the park, put them
to sleep

9th

10th

9th

10th

11th

12th

9th

10th

11th

12th

11th

12th

Begin
Mo/Y
r

End
Mo/Y
r

june
/20
16
mar
ch/2
014

Aug
ust
16
201
4-2
017

Weeks
Per
Year

Hours
Per
Week

Weeks
Per
Year

Hours
Per
Week

Weeks
Per
Year

Hours
Per
Week

Hours
Per
Week

(Summer)

(Sch. Yr)

Description of Program

Volunteer and Community Service List unpaid work only.

Babysitter

11th

Educational Preparation Programs List your participation in educational or academic

Program Name

10th

20

20

20

To what use have you or will you put your earnings?

With my esed my mom pay rent, buy groceries and help her with the house bills which include the electricity bill, the cable/internet. With the rest buy clothes for school.

Awards and Honors List and briefly describe the most significant awards you have received since the beginning of 9th grade.
Award or Honor
Description of Award or Honor

Math Student Roll

Award
3.5 or Higher GPA
Award

Being the best student of your math class through the whole year,
meaning you have an A both semesters, behaviour is exceptional
Keeping a 3.5 or higher overall GPA

Award or Honor Type

Academic

Other

Date
Receive
d

Extracurricular Activities List and briefly describe the activities you have been involved in
since the beginning of 9th grade.

Activity

Description of Activity

Key Club

Feed the homeless, serve supper at church

th

10

th

11

th

th

12

Hours
Per
Week

Hours
Per
Year

This worksheet is adapted from the Activities and Awards Worksheet portion of the application for admissions to the University of California.