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Student Nomination Form for the Facilitated Admission International Recruitment at the University of Toronto Scarborough (FAIR UTSC)

多倫多⼤學⼠嘉堡校區⼤學之道專案學⽣推薦表格 To the FAIR UTSC applicant: Please ask your high school principal, vice principal or academic director to complete this recommendation form either in English or Chinese and return it to you in the envelope with the school official stamp across the seal area. Please submit this form in the sealed envelope together with your application. If it is not included or the seal is tampered, we will not consider your application. 致大學之道的申請學生： 下載並打印這份推薦表格後，請交到就讀高中校長，副校長，教務處處長／主任或學務處處長／主任用英文或者中文填寫以下表格。填寫完後用學校信封封印，並在信封黏貼處加蓋學校公章。如果提交推薦表格時信封已被拆封，將怒不接受大學之道的入學申請。

Part One: Basic information about the applicant 第⼀部份：學⽣基本信息

Last Name 姓： First Name 名： Gender 性别

Date of birth (yyyy/mm/dd): 出⽣日期（年/月/日）:

Date of enrollment (yyyy/mm/dd): 在校就讀時期（年/月/日):

Name of School 學校名稱（全名）：

City/Township 縣／市：

Part Two: Academic performance of the applicant 第⼆部分: 學⽣學業表現 Academic ranking among all Senior Three/Grade 12 classes: 該考⽣成績在⾼三／12年級的排名位置：

Lower percentage the better (5%排名為最優秀，50%中等，Below50%中下等) ___ 5% ___10% ___20% ___30% ___50% ___Below 50%

English proficiency of the applicant (Listening, Speaking, Writing and Reading): 該考⽣英語⽔平在⾼三／12年級的位置（包含聽說讀寫）：

Lower percentage the better (5%英語能⼒為最優秀，50%中等，Below50%中下等) ___ 5% ___10% ___20% ___30% ___50% ___Below 50%

If the applicant was to participate in next year’s General Scholastic Ability Test（or the Advanced Subject Test）, based on the applicant’s academic potential, under which category would you expect the student be admitted in Taiwan’s higher education system? Please choose one only. Skip to the next question if the applicant plans to pursue post-secondary education outside of Taiwan.

• Tier-one universities (key universities) • Tier-two universities (provincial or municipal level university) • Community colleges • Others, please describe

依照該⽣目前在校成績和預估未來學測（或指考）的表現，該⽣可獲得以下哪類台灣⼤專院校的錄取資格（請單選，計畫出國留學的不用填寫）

o 公立頂尖⼤學 （遠見雜誌等台灣⼤學排名前10名） o 其他公私立⼤學 o 科技⼤學，技術學院，專科學校 （請舉例） o 其他，請說明

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If the applicant was to apply to study at an university overseas, based on his or her academic performance and potential, what type of post-secondary school would the student be admitted to? Please only choose one.

• World renowned universities (top 100 universities in the QS or THE ranking system) • Universities ranked outside the world’s top 100 universities • Community colleges or vocational schools • Others, please describe

依照目前該⽣在校的成績表現， 如想出國留學，學⽣⾼中畢業後可獲得以下哪類學校錄取 （請單選）。

• 海外知名⼤學（THE，QS等世界⼤學排名前100的⾼校） • 海外⼀般⼤學 • 海外社區⼤學 • 其他，請說明

Please briefly describe how the applicant upholds a high standard of academic integrity. 請簡要敘述該⽣在校總體的學術誠信表現。

Please briefly comment on the applicant’s academic performance and classroom attendance and of the student’s plans to study abroad may have impacted their high school studies. 請簡要說明該⽣在校期間的學習狀況和出勤表現，是否會因為打算出國留學⽽影響在貴校⾼中的課程學習。 Part Three: Appraisal of applicant’s personal qualities throughout his/her secondary education 第三部份：對學⽣在⾼中就學階段的性格和其他能⼒表現 Please rate the applicant on the following qualities from your best knowledge and experience (5% top, 50% in the middle) 依據您的經驗與了解，請在下列問題中選擇最能夠代表該考⽣的 （5%⾼中總體表現為最優秀，50%中等，Below 50%中下等）

Independence (獨立性) ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Originality/Creativity (原創性) ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Motivation/Perseverance (機動性) ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Interpersonal skills （⼈際關係技巧) ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Integrity (誠實守信） ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Intellectual ability (智⼒能⼒表現) ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Written/Oral communication skills (說和寫的溝通能⼒) ___ 5% ___10% ___20% ___30% ___50% ___Below 50% Future growth capacity (未來發展潛⼒) ___ 5% ___10% ___20% ___30% ___50% ___Below 50%

Please provide a brief description if the applicant has participated in any societal or volunteer activity in the community or been involved in any extracurricular activity or engaged in any student leadership position at the school. 請簡要說明該⽣在校期間，是否參與社會實踐活動，義⼯服務或在校擔任班級，年級，校級學⽣⼯作。

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Please briefly describe if the applicant was awarded any prizes in a provincial, municipal or school-wide competition in areas such as academic subject competitions, athletic tournaments, art performances, project innovations, etc. 請列出並簡要介紹該考⽣獲得的重要獎項及參與過的競賽 （例如學科競賽，體育技能，才藝表演，創新項目等）。 Please describe how the applicant demonstrates excellent communication skills with students, staff and faculty of the school. 請簡要說明該⽣在校期間與教師職員和同學之間的溝通能⼒與互動。 Part Four: Recommendation 第四部分：推薦結論 My final decision of recommendation (Please select ONE) for the undergraduate admission to the University of Toronto Scarborough through the FAIR UTSC Program: 對於我校該⽣透過⼤學之道專案申請多倫多⼤學⼠嘉堡校區，我的最後推薦決定是（請單選）：

o Highly Recommend （強⼒推薦 ）

o Recommend (推薦)

o Do not recommend （不推薦） Additional comments (其他品論）: Part Five: A brief introduction of your high school 第五部份：學⽣就讀學校的簡要介紹 Please describe the school in terms of its academic reputation, sources of student enrolment, GSAT/AST results, guiding principles, teaching strength etc. Please attach the school profile. 請依貴校在當地的名譽，學生來源，指考／學測表現，畢業生的大學走向，師資力量等重要辦學理念來介紹校園特色. Approximately how many graduates look to pursue their post-secondary education abroad? 貴校每年畢業後選擇出國留學約有多少學⽣？ Your school’s admission rate to well-known, domestic universities： 貴校學⽣成功升⼊國內知名⼤學(遠見雜誌排名前⼗名)的升學率：

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Part Six: Nominator information 第六部份：推薦人信息 Nominator name in Chinese or English /推薦⼈姓名: ______________________ Title of the nominator / 推薦⼈職務: __________________________ How long have you been aware of the FAIR UTSC Program? /對於多倫多⼤學⼠嘉堡校區⼤學之道 專案的了解已有多長時間？ __________________________ Signature / 推薦⼈簽名: ___________________________________ Date / 日期: ____________________________________________ We deeply appreciate you sharing your insights on the applicant. Your recommendation and feedback will be instrumental in making our admission decisions. This document is part of the candidate’s application materials, which will be kept secure and confidential. 衷⼼地感謝您抽出寶貴時間給考⽣提出的推薦意見，這些將會對我們錄取⼯作帶來很⼤的便利和幫助。此⽂件是考⽣申請材料的⼀部份，我們收到後會妥善保管以保護學⽣隱私。

School Official Stamp 學校印章