ConfidentialBELLARMINE-JEFFERSON HIGH SCHOOL

 

465 E. Olive Ave. i Burbank, CA 91501-2175 i (818) 972-1400 i Fax: (818) 559-6387 i

 

 

School Recommendation for Applicant

 

Name of Applicant_______________________________________________________ Applying for Grade_______________

 

 


This form is to be completed by school officials: English and Mathematics teachers are encouraged.  The evaluation will be used by persons on the Admissions Committee and will not become part of the student's cumulative folder, therefore, this form will not be open to general review. Thank you for your time in preparing this report. Your carefully considered judgement will have a direct bearing on this student's acceptance.

 

Name of School_________________________________________________________  Student Entry Date_______________

 

In relation to other students in the applicant's age group, please check the appropriate box for each item below.

 

Student Rating

Excellent

Good

Average

Poor

Motivation:                                                                                       Committed to learning; attentive to goals; inclined to complete tasks; works beyond minimal expectation.

 

 

 

 

Sense of Responsibility:                                                                                     Concerned with welfare and rights of others; respects others'/school's property; follows school rules/regulations.

 

 

 

 

Personal Relationships:                                                                                     Works well in groups; liked by students/adults; relates to peers and adults in a respectful manner.

 

 

 

 

Initiative and Leadership:                                                                                    Often called upon to lead group activities; voluntarily participates in class and co-curricular activities..

 

 

 

 

General Conduct/Effort

 

Cooperation 

 

 

 

 

 

 

 

 

 

 

Work and Study Habits

 

 

 

 

 

 

Comments on areas above_______________________________________________________________________________________________

 

____________________________________________________________________________________________________________________

 

Attendance at School:                                          Number of Absences ________________           Number of Tardies ________________

 

 

If the student is an 8th grader applying for the 9th Grade, and is currently enrolled in a  2 semester Algebra I course, check here      q

 

 

1.        If this students is in any advanced sections or programs in your school, please explain __________________________________________

______________________________________________________________________________________________________________

 

2.        In which areas do you feel this student needs improvement?______________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

 

 

--  Page 1 of 2  --

 

3.        Has the student been recognized for any outstanding academic, athletic and/or artistic performance?

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

 

4.        Please note any special health problems ______________________________________________________________________________

 

5.        Has the student been subjected to any serious disciplinary procedures (i.e., suspension, dismissal, etc.)?

_________No               ___________Yes          If yes, please explain _______________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

6.        ConfidentialIs there any additional information that you think might or should influence our decision about this student?

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

 

Recommendation:

 

                                                                                                                                Academically                          As a Person

 

1.        I strongly recommend this student.                                                                                __________                            __________

2.        I recommend this student.                                                                              __________                            __________

3.        I recommend this student with reservations. (Please state your reservation below)

4.        I do not recommend this student. (Please state your reason below)

 

______________________________________________________________________________________________________________

 

5.        Please call the Principal.

 

In the event they are not accepted, do you give permission to include this recommendation if redirection to another school is requested.

_________No               ___________Yes

 

If this student is tentatively accepted and enrolls in our school for the following year, we will request the 2nd (or final)  semester grades as a final acceptance determinant. If you have any reason to change your recommendation after you have completed this form, please notify the principal.  Thank you for the time you have taken to prepare this report. Your carefully considered judgements will have a direct bearing on the candidate's application.  If you have sent the records to another high school, please indicate below:

 

High School ___________________________________________________   Date ___________________________

 

High School ___________________________________________________   Date ___________________________

 

Signature of Counselor for High School Transfer Students or Eighth Grade Teacher for Incoming 9th Grade Students:

 

________________________________________________________________________________                Date_____________________

Signature                                                                                                                 Title

 

Signature of Principal

 

________________________________________________________________________________                Date_____________________

Signature                                                                                                                

 

 

School______________________________________________________________________   Telephone___________________________

 

This form should be mailed directly from the current school to

Admissions Office

Bellarmine-Jefferson High School

465 E Olive Ave., Burbank, CA  91501

 

--  Page 2 of 2  --