Common Confidential Student Evaluation Form (2nd- 8th Grade Applicants) - Independent Schools of the San Francisco Bay Area

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Independent Schools of the San Francisco Bay Area
nd
th
Common Confidential Student Evaluation Form (2
- 8
Grade Applicants)
www.issfba.org
Child’s name ____________________________________ Date of birth _______________ Applying to grade ______
last
first
middle
month/day/year
To the parent/guardian:
Print the above information and read and sign the statement below. Give this form to the child’s teacher(s)
with a stamped envelope addressed to the school(s) to which your child is applying.
For the child named above, I give permission for you to release the information on this form to the school(s) to which I
am applying and understand that I will not have access to this confidential information. In addition, I permit my child’s
current school staff to speak with any inquiring admission staff. All communication between schools will remain
confidential and I will not have access to the content of any conversation.
Name of parent/guardian (please print) ___________________________________________________
Date __________________
Signature of parent/guardian ____________________________________________________________________________________
To the teacher:
It is only necessary to complete this form once. Consult with the child’s parent/guardian regarding the school(s) to
which the family is applying. Please photocopy this completed form and send it directly to the school(s); file the original for your records.
We sincerely appreciate your cooperation in helping to evaluate this applicant and assure you that this information will be held in
confidence. Please be sure the parent/guardian has signed above.
How long have you known this child?
Is English child’s primary language?
Language
(if not English)
What three words come to mind when describing this child?
________________________________
/
________________________________
/
________________________________
What inspires this child? What discourages this child?
For each item in the table below, please check the most developmentally age-appropriate description of this child.
Did Not
Needs
Noticeably
Age Appropriate
Personal Characteristics
Observe
Improvement
Emerging
Developing
Consistent
Advanced
Exceptional
Ability to work in a group
Ability to work independently
Intellectual curiosity
Imagination
Motivation/Effort
Leadership potential
Classroom conduct
Self-confidence
Respect for teachers
Reaction to criticism
Integrity/Trustworthiness
Persistence
Relationship with peers
Accepts responsibility for actions
Uses language to problem solve
Demonstrates self-control
Consideration of others
Maturity
Sense of humor
Seeks advice/help when needed
Comments
: ______________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Revised June 20, 2013
2nd – 8th Grade Common Student Evaluation Form
Page 1 of 2
Independent Schools of the San Francisco Bay Area
nd
th
Common Confidential Student Evaluation Form (2
- 8
Grade Applicants)
www.issfba.org
Child’s name ____________________________________ Date of birth _______________ Applying to grade ______
last
first
middle
month/day/year
To the parent/guardian:
Print the above information and read and sign the statement below. Give this form to the child’s teacher(s)
with a stamped envelope addressed to the school(s) to which your child is applying.
For the child named above, I give permission for you to release the information on this form to the school(s) to which I
am applying and understand that I will not have access to this confidential information. In addition, I permit my child’s
current school staff to speak with any inquiring admission staff. All communication between schools will remain
confidential and I will not have access to the content of any conversation.
Name of parent/guardian (please print) ___________________________________________________
Date __________________
Signature of parent/guardian ____________________________________________________________________________________
To the teacher:
It is only necessary to complete this form once. Consult with the child’s parent/guardian regarding the school(s) to
which the family is applying. Please photocopy this completed form and send it directly to the school(s); file the original for your records.
We sincerely appreciate your cooperation in helping to evaluate this applicant and assure you that this information will be held in
confidence. Please be sure the parent/guardian has signed above.
How long have you known this child?
Is English child’s primary language?
Language
(if not English)
What three words come to mind when describing this child?
________________________________
/
________________________________
/
________________________________
What inspires this child? What discourages this child?
For each item in the table below, please check the most developmentally age-appropriate description of this child.
Did Not
Needs
Noticeably
Age Appropriate
Personal Characteristics
Observe
Improvement
Emerging
Developing
Consistent
Advanced
Exceptional
Ability to work in a group
Ability to work independently
Intellectual curiosity
Imagination
Motivation/Effort
Leadership potential
Classroom conduct
Self-confidence
Respect for teachers
Reaction to criticism
Integrity/Trustworthiness
Persistence
Relationship with peers
Accepts responsibility for actions
Uses language to problem solve
Demonstrates self-control
Consideration of others
Maturity
Sense of humor
Seeks advice/help when needed
Comments
: ______________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Revised June 20, 2013
2nd – 8th Grade Common Student Evaluation Form
Page 1 of 2
For each item in the tables below, please check the most developmentally age-appropriate description of this child.
Did Not
Needs
Noticeably
Age Appropriate
Academic Performance
Observe
Improvement
Emerging
Developing
Consistent
Advanced
Exceptional
Academic ability
Academic performance
Participation in discussions
Ability to express ideas orally
Ability to express ideas in writing
Follows directions
Prepared for class
Attention span
Use of class time
Seeks help when needed
Comments: _________________________________________________________________________________________________
Did Not
Family Information
Observe
Rarely
Sometimes
Usually
Consistently
Has realistic expectations for their child
Communicates openly with the school
Follows the rules and policies of the school
Cooperates with classroom teachers
Follows through with school recommendations
Cooperates with school administration
Participates in school activities
Is punctual with drop-off and pick-up procedures
Comments: _________________________________________________________________________________________________
___________________________________________________________________________________________________________
What are this child’s greatest strengths?
What are this child’s challenges?
Describe this child’s approach to learning (hands on, visual, kinetic, auditory, logical) and/or what kind of classroom environment would
be a good match for this child.
Child’s enrollment period at your school:
Start Date
Month:
Year:
End Date
Month:
Year:
.
SPECIFIC RECOMMENDATION:
 Recommended
 Recommended with reservations (please
 Prefer not to make a recommendation (please
explain below)
explain below)
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
 Check here if any information pertaining to this child/family would be better communicated by phone. Please feel free to
add further narrative on additional page(s) if desired.
Form completed by (print name) ____________________________________
Position
Date ___________________
Your signature _________________________________________________
Email
Phone __________________
School Name___________________________________________________
Director/Principal’s Email ___________________________________
Director/Principal’s Name _________________________________________
Director/Principal’s Phone ___________________________________
Revised June 20, 2013
2nd – 8th Grade Common Student Evaluation Form
Page 2 of 2

Download Common Confidential Student Evaluation Form (2nd- 8th Grade Applicants) - Independent Schools of the San Francisco Bay Area

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