To Be Completed by Administrator Or Teacher from Applicant S Previous School

RECOMMENDATION FORM To be completed by administrator or teacher from applicant’s previous school

The following student has applied for admission to First Immanuel Lutheran School and has given permission to seek a recommendation from you.

Child’s Name: Date of Birth:

Parent’s Name: Phone Number:

Please give your evaluation of this student, based on actually observed situations.

Special talents, interests and/or abilities:

Does the student have any significant limitations that affect school performance?  Yes  No

If yes, please explain:

Has the student missed more than 10 days of school during any school year?  Yes  No

Has the student been referred to the school office for disciplinary action?  Yes  No

Please explain:

Is the student eligible to return next year?  Yes  No

How long have you known the applicant?

Parent cooperation and involvement with the school:

Is there anything significant about the home life which will help us understand this student?

I recommend this student for admission:  With great enthusiasm  With confidence  With reservation  I do not recommend

Please feel free to use the back of this form to give any additional comments that would help in understanding this student.

Name of Person Completing Form: Position:

School Name: Phone number:

Signature: Date:

THIS EVALUATION MAY BE SHARED WITH THE STUDENT AND/OR FAMILY UNLESS YOU SPECIFICALLY REQUEST THAT IT BE KEPT CONFIDENTIAL. Please mail, email or fax recommendation to Principal Dawn Walker First Immanuel Lutheran School W67 N622 Evergreen Blvd., Cedarburg WI 53012

[email protected] phone 262/377-6610 fax 262/377-9606