Middle School/High School

STUDENT REFERENCE FORM

MIDDLE SCHOOL/HIGH SCHOOL

GRADES 6 to 12

To be completed by the student'sEnglish teacher

Thank you for taking the time and consideration to complete this form. The above student has applied for admission to the International School of Kigali, Rwanda. This reference is an important part of the application process. Please return the completed form to the admission office at . If the form is returned by the family, please place it in a sealed envelope, with an official school stamp.

Thank you for your cooperation.

Last name: ……………………………………….

First name: ……………………………………….

Applying for grade: ………………………………

Name & address of present school
School phone
Fax
Website
E-mail
Name of the person submitting evaluation
Position
E-mail
Phone
Years employed at this school
Length of time acquainted with the student:
How often do you have contact with the applicant? / Daily
Weekly
Occasionally

PLEASE INDICATE YOUR OPINION OF THE STUDENT IN THE FOLLOWING AREAS

ACADEMIC QUALITIES / WORK HABITS

Please use an A,B,C,D,E scale with A being the top rating.

Academic qualities/work habits / A / B / C / D / E
Organizes time and materials
Works independently
Works well in group activities
Listens to / Follows directions
Participates in discussions / activities
Demonstrates self discipline
Overall academic performance
Academic motivation
Intellectual curiosity
Overall Academic Potential

PERSONAL DEVELOPMENT

Please use an A,B,C,D,E scale with A being the top rating.

Personal Development / A / B / C / D / E
Exhibits self-confidence
Relates well with peers
Shows concern for others
Respects rights / property of others
Shows courtesy / Respect
Demonstrates leadership ability
Accepts constructive criticism
Overall Character

OTHER:

Please describe

What three words best describe this student's academic abilities?
What three words best describe this student's personal character?
Please describe this student's academic strengths and weaknesses in terms of his/her reading comprehension and writing skills. If there are any problems, please indicate them.
Have there been any disciplinary, emotional or other concerns? Please explain
In your opinion, how will this student adapt to a new school in an international environment in which English is the language of instruction?
Is there anything we should know about this student's English language skills that may limit his or her success?
In your opinion, to what degree does this student have an appropriate level of English to access and succeed in the AP (Advanced Placement) Program in grades 11 and 12 – a rigorous college preparatory exam?

Date: …………………………………….

Signature: ……………………………….

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ISKR | BP 6217, Kigali, Rwanda | | Email: | Tel: (+250) 0786735469