Grade 2 - 6 Recommendation Form 2014-15 - Potomac School
Grade 2 - 6 Recommendation Form 2014-15 - Potomac School
Grade 2 - 6 Recommendation Form 2014-15 - Potomac School
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Independent <strong>School</strong> Student <strong>Recommendation</strong><br />
Confidential<br />
<strong>Grade</strong>s 2 - 6<br />
Name of Student ________________________________________Application for <strong>Grade</strong> ___________<br />
Name of current teacher. ______________________ I have known this candidate ___ / __years/months.<br />
My relationship has been that of _________________________________________________________.<br />
For parents: I hereby waive my right to access this recommendation and authorize the above-named<br />
person to provide an evaluation and all relevant information to the school for purposes of my or my<br />
child’s application to attend the school.<br />
Parent signature: ______________________________________________ Date: __________________<br />
For persons submitting recommendation: The <strong>School</strong> would appreciate your candid assessment of the<br />
applicant’s abilities. If the applicant’s parent has signed the waiver above, your recommendation will be<br />
kept confidential.<br />
What are the first words which come to mind in order to describe this candidate?<br />
What are the applicant's special interests?<br />
Does the applicant receive any program modifications or accommodations? Please describe.<br />
Study habits<br />
Self-motivation<br />
Organization of time and<br />
work<br />
Intellectual curiosity<br />
Attention Span<br />
Ability to express ideas orally<br />
Ability to follow directions<br />
Ability to work in a group<br />
Ability to work independently<br />
Perseverance<br />
Academic promise<br />
Academic achievement<br />
Attendance<br />
Parent cooperation<br />
Parent involvement in school<br />
affairs<br />
Excellent Good Fair Poor Comments<br />
Reads for pleasure Much Some Little
Eleven traits are listed in the left hand column. Check the category on the right which best describes the<br />
candidate. Adjust the placement of the check mark to left or right within a given section to indicate<br />
gradations - left side being high in the category - right side being toward the next category.<br />
Conduct<br />
Consideration for others<br />
Social relationship with<br />
peers<br />
Usually good<br />
conduct<br />
Unusually<br />
considerate<br />
Very healthy<br />
relationships<br />
Occasional good<br />
conduct<br />
Usually<br />
considerate<br />
Healthy<br />
relationships<br />
Misconduct<br />
Inconsiderate<br />
Occasional minor<br />
problems<br />
Frequent<br />
disruptions<br />
Unkind<br />
Relates poorly<br />
Leadership ability Excellent Good Average Poor<br />
Emotional maturity Very mature Average<br />
Self-confidence<br />
Healthy selfimage<br />
Needs some<br />
support<br />
Sense of humor Highly developed Well developed<br />
Integrity Very trustworthy Trustworthy<br />
Sense of responsibility<br />
Responsible<br />
Usually<br />
responsible<br />
Somewhat<br />
immature<br />
Needs much<br />
support<br />
Average<br />
development<br />
Usually<br />
trustworthy<br />
Sometimes<br />
responsible<br />
Very immature<br />
Poor self-image<br />
Poorly developed<br />
Untrustworthy<br />
Rarely<br />
responsible<br />
Relationship with adults Very comfortable Comfortable Is dependent on Avoids contact<br />
Participation in<br />
extracurricular activities<br />
Comments<br />
Enthusiastic<br />
participation<br />
Frequent<br />
participation<br />
Occasional<br />
participation<br />
Rarely<br />
participates<br />
____________________________________<br />
Signature<br />
____________________________________<br />
<strong>School</strong><br />
____________________________________<br />
Please print or type name<br />
____________________________________<br />
<strong>School</strong> phone number<br />
Please return this form directly to:<br />
The Admission Office, The <strong>Potomac</strong> <strong>School</strong><br />
1301 <strong>Potomac</strong> <strong>School</strong> Road<br />
McLean, Virginia 22101<br />
(703) 749-6313
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