Applicant’s Name:

    Applying for Grade Level:

    Instructions: Give one recommendation form each to any two of the following people in your school: the Principal, Prefect of Discipline, Guidance Counselor, or Class Adviser. Preferably a person who knows you well enough to make a well founded recommendation.

    TO THE SCHOOL REPRESENTATIVE:

    Person Completing the Form:

    Designation:

    Name and Address of School:

    Phone:

    Instructions: We appreciate the time taken to complete the Recommendation Form for this applicant to Southridge School. Your honest response will facilitate an appropriate evaluation of his application. The information you submit will be considered confidential.

    PRELIMINARY INFORMATION:

    How long have you known the applicant and in what capacity?

    What are the first few words that come to mind to describe the applicant?

    Please indicate overall rank

    in class:Top 10%Top 25%Middle 50%Lower 25%

    Has the applicant received disciplinary action in your school? YESNO

    Others:

    If yes, reason for disciplinary action:

    We would appreciate any additional information/comment that may help our school make an informed decision on the application of the student.

    ACADEMIC QUALITIES: Please rate the applicant in terms of the following academic qualities:

    Qualities

    Comments

    Study Habits

    OutstandingAbove AverageAverageBelow Average

    General Aptitude

    OutstandingAbove AverageAverageBelow Average

    Motivation

    OutstandingAbove AverageAverageBelow Average

    Intellectual Curiosity

    OutstandingAbove AverageAverageBelow Average

    Ability to Work Independently

    OutstandingAbove AverageAverageBelow Average

    Problem Solving Skills

    OutstandingAbove AverageAverageBelow Average

    Critical and Abstract Thinking Skills

    OutstandingAbove AverageAverageBelow Average

    Ability to Work Creatively

    OutstandingAbove AverageAverageBelow Average

    Ability to Organize and Communicate Ideas

    OutstandingAbove AverageAverageBelow Average

    PERSONAL QUALITIES: Please rate the applicant in terms of the following personal qualities:

    Qualities

    Comments

    Leadership

    OutstandingAbove AverageAverageBelow Average

    Peer Relationships

    OutstandingAbove AverageAverageBelow Average

    Sense of Humor

    OutstandingAbove AverageAverageBelow Average

    Creativity

    OutstandingAbove AverageAverageBelow Average

    Positive Reaction to Criticism

    OutstandingAbove AverageAverageBelow Average

    Self-Confidence

    OutstandingAbove AverageAverageBelow Average

    Integrity

    OutstandingAbove AverageAverageBelow Average

    Taking Responsibility for Own Actions

    OutstandingAbove AverageAverageBelow Average

    Involvement in Activities Outside the Classroom

    OutstandingAbove AverageAverageBelow Average

    PARENTAL INVOLVEMENT:

    Very InvolvedUsually InvolvedRarely InvolvedNot Involved

    OVERALL RECOMMENDATION:

    Thank you for accomplishing the form