CONFIDENTIAL RECOMMENDATION FORM

____________________________is applying for admission to St. Mary’s School.  One of the requirements for admission is a recommendation from a current classroom teacher.  Please complete this form and return it to: 

St. Mary’s School, Attention:  Vice Principal,1665 Hwy 45 ByPass, Jackson, TN  38305.

ACADEMIC QUALITIES (please check)

Academic potential

__ limited    __ fair     __average    __ excellent

Academic achievement

__ limited     __fair     __average    __excellent

Motivation

__does very little     __ some   __well motivated     __sets high goals

Ability to work in a group

__ needs much supervision     __ needs help occasionally    __always works well

Ability to work alone

__needs much supervision     __needs help occasionally     __always works well

Ability to write

__ limited ideas and mechanics     __ good ideas and mechanics     __excellent ideas and mechanics

Participation in discussion

__ rarely     __ when called on     __ joins in readily     __ wants to dominate

Follows directions

__needs much explanation     __ occasionally needs help     __ quickly and correctly

PERSONAL QUALITIES

Attention span

__easily distracted     __ occasionally distracted     __good     __very good

Classroom conduct

__frequently disruptive     __occasional misconduct     __usually good behavior  __outstanding behavior

Respect for others

__rarely shows respect     __usually respectful    __very respectful

Use of time

__ uses poorly     __ occasionally wastes     __ usually uses well     __always uses effectively

Maturity in terms of grade

__very immature     __somewhat immature     __normal     __above average     __very mature 

Cooperation with faculty and staff

__rarely     __sometimes     __usually     __always

Does this student receive support services? (gifted, remedial, resource, tutoring).  Please explain. 

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Please add comments which you believe would be helpful in assisting us in providing a beneficial educational program for this student.

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Thank you for your responses.

Your name: ___________________________________________________________________________

Title:  _________________________ School:  _______________________________________________

Address: _____________________________________________________________________________

City: ___________________________    State:__________________      Zip:______________________

How long have you known this student? ____________________________________________________

In what capacity? ______________________________________________________________________

Signature:_____________________________________________________________________________