YESHIVA DARCHEI TORAH
18 Champlain Boulevard · Toronto, Ontario M3H 2Z1
Telephone: (416) 782-7974 · Fax: (416) 782-7811
CONFIDENTIAL ASSESSMENT – RELIGIOUS
Parents: Please give this form to your son’s Rebbe or principal for completion.
Referee: Please mail or fax this form to the Yeshiva office.
The applicant named below is applying for admission to Yeshiva Darchei Torah and has given your name as a referee. We are eager to select those individuals whose accomplishments, personal attributes, and abilities indicate that they have the greatest potential for achieving success in a Yeshiva.
NOTE: If you do not know the applicant well enough to make a valid assessment, it would be in the interest of both the applicant and the Yeshiva for you to decline the invitation to act as a referee.
Name and Address of Applicant / Name and Address of RefereePlease complete the following:
CHARACTER EVALUATION
Outstanding(Top 10%) / Good / Average / Below Average / No Basis for Judgment
Honesty
Cooperation
Positive Acceptance of Criticism
Leadership
Maturity
Sensitivity to Others
Religious Commitment
Personal Appearance
ACADEMIC EVALUATION
Outstanding(Top 10%) / Good / Average / Below Average / No Basis for Judgment
Motivation
Study Habits
Attention Span
Ability
Diligence
1. In what capacity have you been associated with the applicant? (e.g. Rebbe, Principal, Teacher, etc.)
2. How long have you known the applicant?
3. How well do you know the applicant?
_____ Very Well _____ Fairly Well _____Slightly
4. Has this student distinguished himself in any way during the period of your acquaintance?
5. Has this student received special support (e.g. tutoring, program modification) during the period of your acquaintance?
6. To the best of your knowledge has the applicant ever been involved in any activity that might be unacceptable for a Yeshiva student (e.g. reading or viewing inappropriate books, magazines, or movies; using foul language; substance abuse; fraternizing with girls, etc.)? If yes, please specify.
7. Is this student disruptive in class for any reason (e.g. fighting, chattering, fidgeting)?
8. Is this student capable of organizing his time and possessions?
9. Does this student accept authority?
10. Are this student’s skills (e.g. writing, reading comprehension, etc.) appropriate for his age?
Comments:
______
Signature of Referee Date
Confidential General Academic Assessment – Page 1
Confidential General Academic Assessment – Page 1
YESHIVA DARCHEI TORAH
18 Champlain Boulevard · Toronto, Ontario M3H 2Z1
Telephone: (416) 782-7974 · Fax: (416) 782-7811
CONFIDENTIAL ASSESSMENT – GENERAL ACADEMIC
Parents: Please give this form to your son’s teacher or principal for completion.
Referee: Please mail or fax this form to the Yeshiva office.
The applicant named below is applying for admission to Yeshiva Darchei Torah and has given your name as a referee. We are eager to select those individuals whose accomplishments, personal attributes, and abilities indicate that they have the greatest potential for achieving success in a Yeshiva.
NOTE: If you do not know the applicant well enough to make a valid assessment, it would be in the interest of both the applicant and the Yeshiva for you to decline the invitation to act as a referee.
Name and Address of Applicant / Name and Address of RefereePlease complete the following:
CHARACTER EVALUATION
Outstanding(Top 10%) / Good / Average / Below Average / No Basis for Judgment
Honesty
Cooperation
Positive Acceptance of Criticism
Leadership
Maturity
Sensitivity to Others
Religious Commitment
Personal Appearance
ACADEMIC EVALUATION
Outstanding(Top 10%) / Good / Average / Below Average / No Basis for Judgment
Motivation
Study Habits
Attention Span
Ability
Diligence
1. In what capacity have you been associated with the applicant? (e.g. Rebbe, Principal, Teacher, etc.)
2. How long have you known the applicant?
3. How well do you know the applicant?
_____ Very Well _____ Fairly Well _____Slightly
4. Has this student distinguished himself in any way during the period of your acquaintance?
5. Has this student received special support (e.g. tutoring, program modification) during the period of your acquaintance?
6. To the best of your knowledge has the applicant ever been involved in any activity that might be unacceptable for a Yeshiva student (e.g. reading or viewing inappropriate books, magazines, or movies; using foul language; substance abuse; fraternizing with girls, etc.)? If yes, please specify.
7. Is this student disruptive in class for any reason (e.g. fighting, chattering, fidgeting)?
8. Is this student capable of organizing his time and possessions?
9. Does this student accept authority?
10. Are this student’s skills (e.g. writing, reading comprehension, etc.) appropriate for his age?
Comments:
______
Signature of Referee Date
Confidential General Academic Assessment – Page 1