Student Recommendation Form

Student Name

First Last

Current Grade Level

Current School

Principal

School Address

Street Address Address Line 2 City State ZIP Code

School Phone Number

School Fax Number

I give permission for my child’s current principal/teacher to complete this recommendation form. I understand that it is a required component of the applications process.

Parent/Guardian Signature

Date

MM

DD

YYYY

Please have current school complete the following:

Please answer the following questions in regards to the above named student.

1. This student has received small group instruction assistance, LD remedial tutoring, or other supplemental support services.

Yes
No

If yes, please list areas and the year (s) in which the student received assistance:

2. This student is on an ISP, IEP, 504, action plan or building plan

Yes
No

If yes, please list areas it covers:

3. This student’s family have taken care of their Financial obligation to our school in a timely manner.

Yes
No

Circle one number per question

1=No, Hardly ever
5=Yes, Almost always

1. This student consistently follows teacher’s instructions.

2. This student stays calm while accepting criticism.

3. This student is respectful and does not argue with authority.

4. This student puts forth effort in school.

5. This student completes homework with quality.

6. This student arrives to school on time

7. This student gets along with other students.

8. This students parents have attended conferences and other required meetings.

This student exhibits recurring disciplinary concerns.

Yes
No

If yes, please explain (i.e. student has had excessive detentions, suspended or expelled)

Completed by

Phone

Date

MM

DD

YYYY

I give permission for my child’s current principal/teacher to complete this recommendation form. I understand that it is a required component of the applications process.

Please have current school complete the following:

Circle one number per question

ST. PETER PARISH

OUR LADY OF THE ROSARY PARISH

HOLY CROSS PARISH

ST. ADALBERT PARISH

I give permission for my child’s current principal/teacher to complete this recommendation form. I understand that it is a required component of the applications process.

Please have current school complete the following:

Circle one number per question

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ST. PETER PARISH

OUR LADY OF THE ROSARY PARISH

HOLY CROSS PARISH

ST. ADALBERT PARISH