Grades 1–12 Recommendation Form

The parent(s)/guardian(s) of the above named student have asked Mounds Park Academy to consider him or her for admission. Our goal is to ensure that each student we accept at MPA experiences success. As an academic teacher, you have been asked to complete this form. Your assistance is essential in evaluating the applicant, and, therefore, a completely candid and thorough evaluation will best serve the interests of the applicant, the applicant's family, and the school. This information will be kept confidential.

How long have you known this applicant and in what capacity?

What words or phrases would you use to describe this applicant?

Please comment on this applicant's academic strengths and opportunities for growth. Indicate interest, motivation, and study habits.

Strengths

Applicants opportunities for growth

Please comment on the following characteristics for this applicant:

honesty, sense of responsibility, potential for leadership, respect for authority, and emotional stability

social relationships with peers, teachers, and other adults

parental/guardian involvement

To your knowledge, has this applicant ever been involved in a serious disciplinary incident? Yes No If yes, please explain.

Is this applicant welcome to attend your school next year? Yes No

Please rank the characteristics which generally apply to this applicant.
(A=almost always observed; O=often observed; S=sometimes observed; N=never observed; NA=not applicable)

-- A O S N NA respectful	-- A O S N NA excercises leadership	-- A O S N NA understands concepts
-- A O S N NA manages time well	-- A O S N NA cooperative	-- A O S N NA participates in class
-- A O S N NA self-confident	-- A O S N NA works accurately	-- A O S N NA well organized
-- A O S N NA takes initiative	-- A O S N NA involved in activities	-- A O S N NA sought out by classmates

Has this applicant ever been recommended to have an educational, neurological or psychological evaluation?
Yes No

If yes, to your knowledge was the evaluation completed?
Yes No

All things considered, how would you rate the applicant?

Academically:	Socially:
Superior (top 10%)	Easily engages others
Above Average (top 25%)	Comfortable
Average (top 50%)	Needs growth
Below Average (bottom 50%)

Name:

Email:

School Name:

Work Phone:

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