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TO COUNSELOR OR PRINCIPAL
The student listed above is applying for admission to Asociacióon Escuelas Lincoln. Your candid and thoughtful evaluation is helpful to our admissions process, and we thank you for taking the time to complete this confidential reference form. Please return this form in a sealed envelope directly to AEL’s Admissions Office or email a scanned copy to: [email protected] Please be assured that this information will not be shared with the applicant or his/her family.
Name of Applicant: Current Grade Level:
How long have you known this student?
In what capacity? Counselor Principal Classroom Teacher (For ES Only)
PERSONAL & ACADEMIC QUALITIES (Check the box in each area that BEST DESCRIBES this student)
OutstandingAbove
AverageAverage
Below
Average
Academic achievement
English language proficiency
Writing skills
Timely homework completion
1. Is the student in good standing and eligible to re-enroll in your school in the next grade level? Yes No
2. Is the student currently enrolled in an ELL (English Language Learner) program? Yes No
3. Has any disciplinary action been taken due to:
Academic misconduct? Yes No
Behavioral misconduct? Yes No
Yes No
Page 1 of 3
G1. Counselor/Principal Confidential Recommendation
4. Have these actions resulted in probation, suspension or expulsion from your school? Yes No
If “Yes” to any of the above questions, please explain:
5. Please describe the student’s relationships with peers:
Outstanding Above
Average Average
Below
Average
No basis for
judgment
Academic achievement
English language proficiency
Motivation
Honesty/Integrity
Concern for others
Leadership
Involvement in school activities
6. Please describe the student’s interactions with adults:
7. Has additional learning or behavioral support been provided to this student? Or, is the student likely to need additional learning
or behavioral support to be successful? Yes No
If “Yes”, explain:
8. Does this student have any known assessments/evaluations (e.g., psycho-educational, psychological, etc.), or are there plans to
support him/her at school (IEP, 504, accommodations, modifications or equivalents)? Yes No
If “Yes”, explain:
9. Have there been any social/emotional issues or concerns?
If "Yes", explain:
Yes No
10. Has the student missed more than 10 days of school during any school year? Yes No
If “Yes”, explain:
11.
Please feel free to add any additional comments here:
Page 2 of 3
12.
Have applicant's parents been supportive of the school and cooperative in working with teachers, counselors and administration?
Personality Traits (Check any box that BEST DESCRIBES this student)
Aggressive
Anxious
Articulate
Assertive
Cheerful
Confident
Conscientious
Disorganized
Disobedient
Fidgety
Follower
Easily discouraged
Helpful
Honest
Influential
Irritable
Manipulative
Motivated
Negative leader
Passive
Perfectionist
Passive aggressive
Positive leader
Organized
Responsible
Self-centered
Shy
Self-disciplined
Social
Outgoing
Well liked
Unhappy
Others :
Page 3 of 3
Personal Qualities (Check the box in each area that BEST DESCRIBES this student)
Maturity Social Adjustment with Peers Self Confidence
Very mature for age
Age appropriate
Somewhat mature
Very immature
No basis for judgment
Healthy relationships
Occasionally minor problems
Frequent minor problems
Relates poorly
No basis for judgment
Overly confident
Healthy self-image
Needs support
Needs reassurance
No basis for judgment
Conduct Consideration of Others Sense of Humor
Well-behaved
Usually obeys rules
Occasionally misbehaves
Frequently misbehaves
No basis for judgment
Considerate of others
Mostly considerate of others
Rarely considerate of others
Selfish
No basis for judgment
Delightful
Good
Inappropriate
No humor
No basis for judgment
Integrity Extra Involvement
at School in Attitude of Parents
Very trustworthy
Usually trustworthy
Sometime trustworthy
Untrustworthy
No basis for judgment
Art
Band/Choir/Strings
Drama/Dance
Sports
Service Organization/Club
No basis for judgment
Other:
Cooperative
Uninvolved
Overly protective
Aggressive/Insistent
No basis for judgment
Work Habits Excellent Satisfactory Needs Improvement
Considering all of the above, I recommend this applicant for admission to Asociación Escuelas Lincoln:
With great enthusiasm With confidence With reservation
Check here if you would prefer to discuss this applicant over the phone : Yes No
Dr. Mr. Mrs. Ms.
Email:
Name:
Position:
School Name:
Signature: Date:
ASOCIACION ESCUELAS LINCOLN– Andrés Ferreyra 4073; B1637AOS La Lucila; Pcia. Bs. As., Argentina Telephone: 54-11-4851-1700 ext. 109 for Admission Registrar Fax: ext. 108 or 54-11-4851-1791
Email: [email protected] Web: www.lincoln.edu.ar