To be completed by a teacher, administrator or counselor


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 Performance

Please select only one checkbox from each section
Academic Achievement(Required)
Written Expression(Required)
Oral Expression(Required)
Independent Worker(Required)
Preparation for class(Required)
Follows directions(Required)
Participation in discussions(Required)
Work habits(Required)


Response to suggestions/corrections(Required)
Interaction with peers(Required)
Respect for authority(Required)
Ability to work in a group(Required)
Leadership skills(Required)
Positive Influence(Required)

Is there any other pertinent academic information of which we should be aware?(Required)
2. To your knowledge, is the applicant’s family financially responsible?(Required)
Has this student ever received any disciplinary action?(Required)
Have the parents/guardians been fully supportive of your efforts as a teacher?(Required)
Is this student likely to be influenced or influence others(Required)
If you were responsible for a Christian school, would you admit this applicant?(Required)