Teacher Recommendation Form

Please take the time to evaluate this student by thoughtfully and accurately filling in the information below.

Evaluator Information

First Name *

Last Name *

Title *

School or affiliation *

Phone

Email Address

Do we have permission to contact you if we have additional questions? *

Yes

No

Student Information

First Name *

MI

Last Name *

Current grade in School *

About how long have you known this student? *

Performance

How would you rank this student in the following areas? *

	Excellent	Good	Average	Fair	Poor
Motivation	Excellent	Good	Average	Fair	Poor
Works independently	Excellent	Good	Average	Fair	Poor
Works cooperatively	Excellent	Good	Average	Fair	Poor
Intellectual curiosity	Excellent	Good	Average	Fair	Poor
Classroom behavior	Excellent	Good	Average	Fair	Poor
Follows directions	Excellent	Good	Average	Fair	Poor
Creativity	Excellent	Good	Average	Fair	Poor
Initiative	Excellent	Good	Average	Fair	Poor
Organization	Excellent	Good	Average	Fair	Poor
Problem solving	Excellent	Good	Average	Fair	Poor
Leadership	Excellent	Good	Average	Fair	Poor
Responsibilty	Excellent	Good	Average	Fair	Poor
Attendance	Excellent	Good	Average	Fair	Poor

How would you rank this student in the following academic areas (teachers of a preschool applicant do not need to complete this section)?

	Above grade level	On grade level	Below grade level
Reading fluency	Above grade level	On grade level	Below grade level
Reading comprehension	Above grade level	On grade level	Below grade level
Oral Language	Above grade level	On grade level	Below grade level
Writing content	Above grade level	On grade level	Below grade level
Writing style	Above grade level	On grade level	Below grade level
Writing mechanics	Above grade level	On grade level	Below grade level
Math computational skills	Above grade level	On grade level	Below grade level
Math comprehension	Above grade level	On grade level	Below grade level
Problem solving	Above grade level	On grade level	Below grade level
Critical thinking	Above grade level	On grade level	Below grade level

What distinguishes this student from others? *

How would you describe this student to others? *

Does this child have an identified or suspected learning, behavioral, or physical disability, a diagnosed or suspected psychological condition, or another special need? If so, please explain. * 🛈

If you had the option, would you accept this student into your class again? *

Yes

No

Please mention anything else that you feel is relevant to this evaluation.