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Academic Recommendation Form - Student Name

  • Your Name:
    Referral Name
  • Your Email:
    Referral Email
  • Student Name:
    Student Name
  • Parent Name:
    Parent Name
  • Student's Personal Qualities *
      Below Average Fair Average Strong Excellent Not Observed
    Academic Commitment
    Creativity
    Self-Confidence
    Leadership Potential
    Reaction to Criticism
    Concern for Others
    Personal Conduct
    Personal Integrity
    Ability to Act Independently
    Ability to Work Cooperatively
    General Level of Maturity
  • Student's Academic Qualities *
      Below Average Fair Average Strong Excellent Not Observed
    Study Habits
    Attention Span
    Motivation
    Intellectual Curiosity
    Critical and Abstract Thinking Skills
    Follows Oral and Written Directions
    Completes Tasks in a Reasonable Time
  • Do you think the student's test scores accurately reflect actual achievement and ability? *
    Yes   No
  • If no, please explain.
  • Has the student had any special needs identified, adjusted curriculum, or been enrolled in any special education programs?                *
    Yes   No
  • If yes, please explain.
  • Has the student ever been on citizenship or disciplinary probation or have there been behavior problems which have been a consistent concern? *
    Yes   No
  • If yes, please explain.
  • Should the Admissions Office be aware of any factors impact this student's academic or social progress to date (health problems, behavioral concerns, family issues, learning disabilities or learning difficulties)?  *
    Yes   No
  • If yes, please explain.
  • Has attendance been satisfactory? *
    Yes   No
  • If no, please explain.
  • Parental Involvement, if applicable.
      Yes No NA
    Has there been parental cooperation and involvement in school activities?
    Does the student’s family have the ability to meet its financial obligations?
    If yes, have financial obligations been met promptly and satisfactorily?
  • Please submit transcripts/report cards
  • Please submit standardized test scores
  • Is there any additional information that can be better conveyed in a phone conversation ? *
    Yes   No
  • If yes, phone number:
  • THANK YOU for the time and effort you have taken in completing this confidential form. Your comments are very important to us.
  • Signature *
    Date: 06/25/2019
  • Title *

Thank you for your time and effort in completing this evaluation. Please review your answers carefully before submitting the form. Once the form has been submitted it will be sent directly to our admissions office.