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Student Name
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Teacher Name
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Level of instruction
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Lower/Elementary School Questions Only:
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Student reads orally with fluency at grade level
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Student spells well in written work
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Student has proficient phonics skills
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Student writes legibly
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Student reads with understanding
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Student expresses him/herself well in written work
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Student expresses him/herself well orally
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Computes with reasonable speed and accuracy
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Understands math concepts
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Academic (Math) Questions
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Knows basic number facts
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Computes with accuracy
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Math Facts/Computation
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Math Concept Development
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Problem Solving Skills
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Academic (Language Arts) Questions
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Oral Language Skills
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Reading Comprehension
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Writing Skills
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Student Study Habits & Participation in Class
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Academic achievement
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Motivation / effort
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Listens attentively
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Practices self control
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Completes work on time
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Attention span
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Organizational skills
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Has positive attendance record in class
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Participates in classroom discussion
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Asks pertinent questions
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Is attentive when others speak
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Works at level consistent with ability
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Student Personal Characteristics
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Peer relationships
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Accepts responsibility
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Conduct
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Respect for authority
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Personal integrity
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Leadership ability
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Concern for others
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Overall attendance
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Demonstrates positive spirit towards class activities
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Gets along well with peers
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Responds favorably to peers
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Expresses disappointment appropriately
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Parent Information
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Overall parental support and involvement
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Cooperation with faculty
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Expectations for student
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Participation in student's education
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Participation in student's education
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Other Information
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Please select all words that best describe the student?
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Have there been any circumstances (e.g. extended illness, separation, divorce, death in the immediate family) that have interfered with the student's academic performance?
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Is this student served by an IEP, 504 plan or have need of academic accommodations?
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Do you recommend this applicant for admission to Calvary Day School?
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Teacher Information
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