ACADEMIC EVALUATION To be completed by a teacher, administrator or counselor ACADEMIC EVALUATION Name of applicant:(Required) Current Grade(Required) Year for which applying:(Required) Current School(Required) This student is seeking admission to Foothills Christian Middle School. Please complete this form and submit it. This form is confidential and will be used only for purposes of admission. Thank you for helping us to make a true assessment of this student by placing a check in the appropriate box. Please comment freely on the space allowed at the end of this form.Classroom PerformancePlease select only one checkbox from each sectionAcademic Achievement(Required) Outstanding Good Average Below Average Not observed Written Expression(Required) Outstanding Good Average Below Average Not observed Oral Expression(Required) Outstanding Good Average Below Average Not observed Independent Worker(Required) Outstanding Good Average Below Average Not observed Preparation for class(Required) Outstanding Good Average Below Average Not observed Follows directions(Required) Outstanding Good Average Below Average Not observed Participation in discussions(Required) Outstanding Good Average Below Average Not observed Work habits(Required) Outstanding Good Average Below Average Not observed BehaviorHonesty(Required) Outstanding Good Average Below Average Not observed Response to suggestions/corrections(Required) Outstanding Good Average Below Average Not observed Interaction with peers(Required) Outstanding Good Average Below Average Not observed Respect for authority(Required) Outstanding Good Average Below Average Not observed Ability to work in a group(Required) Outstanding Good Average Below Average Not observed Self-discipline(Required) Outstanding Good Average Below Average Not observed Leadership skills(Required) Outstanding Good Average Below Average Not observed Positive Influence(Required) Outstanding Good Average Below Average Not observed Is there any other pertinent academic information of which we should be aware?(Required) Yes No Explain 2. To your knowledge, is the applicant’s family financially responsible?(Required) Yes No If no, please explain Has this student ever received any disciplinary action?(Required) No Detention Suspension Expulsion Explain Have the parents/guardians been fully supportive of your efforts as a teacher?(Required) Yes No Explain Is this student likely to be influenced or influence others(Required) Likely to be influenced Influences Other Explain If you were responsible for a Christian school, would you admit this applicant?(Required) Yes No Additional comments Your Name(Required) Daytime phone(Required) Email(Required) Position:(Required) How long have you known the applicant?(Required) School Name(Required) School Phone(Required) School Address(Required)
