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Rensselaer Polytechnic Institute (RPI)
Students
Parents
Faculty & Staff
Alumni
Apply
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Medal School Profile Form
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Before completing this form, please check to make sure your school is not already a
participating Medal School
.
Please complete the following form if you are interested in becoming a participating Medal School. If you have any questions, please email
medal_program@rpi.edu
.
If you are unable to complete this online form, you may complete the
Medal School form PDF
and mail or fax it to us.
Rensselaer Medal Program
Admissions Office
110 8th Street
Troy, NY 12180
Fax:
518-276-3997
High School Information
High School Name
High School CEEB
Medal Contact Person:
Medal Contact's Title
Medal Contact Email Address:
Medal Contact's School Mailing Address
Medal Contact's School Mailing Address
Country
Street
City
Region
Postal Code
Telephone Number
Number of students in grades 9-12
Number of students in current graduating class
Percentage of students pursuing post-secondary education:
4-year
2-year
Curriculum Information
Please indicate the math and science courses that are offered by your school.
Important Note:
To be eligible to become a Medal School, a high school must offer all of the courses Rensselaer requires for admission, which include biology, chemistry, lab-based physics, and precalculus.
Algebra I (check all that apply)
Algebra I (check all that apply)
College Prep
Honors
Geometry (check all that apply)
Geometry (check all that apply)
College Prep
Honors
Algebra II/Trigonometry (check all that apply)
Algebra II/Trigonometry (check all that apply)
College Prep
Honors
Precalculus (check all that apply)
Precalculus (check all that apply)
College Prep
Honors
Calculus (check all that apply)
Calculus (check all that apply)
College Prep
Honors
AP- Calculus AB
AP- Calculus BC
Does your school offer the IB (International Baccalaureate) curriculum?
Does your school offer the IB (International Baccalaureate) curriculum?
Yes
No
IB Math Courses Offered:
IB Math Courses Offered:
Mathematical Studies SL
Mathematics SL
Mathematics HL
Further Mathematics HL
Math Applications and Interpretations SL
Math Applications and Interpretations HL
Math Analysis and Approaches SL
Math Analysis and Approaches HL
Earth Science/Physical Science (check all that apply)
Earth Science/Physical Science (check all that apply)
College Prep
Honors
Biology/Living Environment (check all that apply)
Biology/Living Environment (check all that apply)
College Prep
Honors
AP
IB
Chemistry (check all that apply)
Chemistry (check all that apply)
College Prep
Honors
AP
IB
Physics- lab-based (check all that apply)
Physics- lab-based (check all that apply)
College Prep
Honors
AP (select below)
IB
AP Physics Courses
AP Physics Courses
AP Physics I/II (algebra-based)
AP Physics C- Mechanics
AP Physics C- Electricity & Magnetism
School Profile
Please upload a copy of your most recent high school profile.
Please include any additional information you wish to share about your program of study:
Electronic Signature
Your Title
Your Email Address
Submit
