TO COUNSELOR OR PRINCIPAL

The student listed above is applying for admission to Asociacióon Escuelas Lincoln. Your candid and thoughtful evaluation is helpful to our admissions process, and we thank you for taking the time to complete this confidential reference form. Please return this form in a sealed envelope directly to AEL’s Admissions Office or email a scanned copy to: admissions@lincoln.edu.ar Please be assured that this information will not be shared with the applicant or his/her family.

Name of Applicant: Current Grade Level:

How long have you known this student?

In what capacity? Counselor Principal Classroom Teacher (For ES Only)

PERSONAL & ACADEMIC QUALITIES (Check the box in each area that BEST DESCRIBES this student)

OutstandingAbove

AverageAverage

Below

Average

Academic achievement

English language proficiency

Writing skills

Timely homework completion

1. Is the student in good standing and eligible to re-enroll in your school in the next grade level? Yes No

2. Is the student currently enrolled in an ELL (English Language Learner) program? Yes No

3. Has any disciplinary action been taken due to:

Academic misconduct? Yes No

Behavioral misconduct? Yes No

Yes No

               Page  1  of  3    

G1. Counselor/Principal Confidential Recommendation

4. Have these actions resulted in probation, suspension or expulsion from your school? Yes No

If “Yes” to any of the above questions, please explain:

5. Please describe the student’s relationships with peers:

Outstanding Above

Average Average

Below

Average

No basis for

judgment

Academic achievement

English language proficiency

Motivation

Honesty/Integrity

Concern for others

Leadership

Involvement in school activities

6. Please describe the student’s interactions with adults:

7. Has additional learning or behavioral support been provided to this student? Or, is the student likely to need additional learning

or behavioral support to be successful? Yes No

If “Yes”, explain:

8. Does this student have any known assessments/evaluations (e.g., psycho-educational, psychological, etc.), or are there plans to

support him/her at school (IEP, 504, accommodations, modifications or equivalents)? Yes No

If “Yes”, explain:

9. Have there been any social/emotional issues or concerns?

If "Yes", explain:

Yes No

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

If “Yes”, explain:

11.

Please feel free to add any additional comments here:

Page  2  of  3

12.

Have applicant's parents been supportive of the school and cooperative in working with teachers, counselors and administration?

Personality Traits (Check any box that BEST DESCRIBES this student)

Aggressive

Anxious

Articulate

Assertive

Cheerful

Confident

Conscientious

Disorganized

Disobedient

Fidgety

Follower

Easily discouraged

Helpful

Honest

Influential

Irritable

Manipulative

Motivated

Negative leader

Passive

Perfectionist

Passive aggressive

Positive leader

Organized

Responsible

Self-centered

Shy

Self-disciplined

Social

Outgoing

Well liked

Unhappy

Others :

Page 3 of 3

Personal Qualities (Check the box in each area that BEST DESCRIBES this student)

Maturity Social Adjustment with Peers Self Confidence

Very mature for age

Age appropriate

Somewhat mature

Very immature

No basis for judgment

Healthy relationships

Occasionally minor problems

Frequent minor problems

Relates poorly

No basis for judgment

Overly confident

Healthy self-image

Needs support

Needs reassurance

No basis for judgment

Conduct Consideration of Others Sense of Humor

Well-behaved

Usually obeys rules

Occasionally misbehaves

Frequently misbehaves

No basis for judgment

Considerate of others

Mostly considerate of others

Rarely considerate of others

Selfish

No basis for judgment

Delightful

Good

Inappropriate

No humor

No basis for judgment

Integrity Extra Involvement

at School in Attitude of Parents

Very trustworthy

Usually trustworthy

Sometime trustworthy

Untrustworthy

No basis for judgment

Art

Band/Choir/Strings

Drama/Dance

Sports

Service Organization/Club

No basis for judgment

Other:

Cooperative

Uninvolved

Overly protective

Aggressive/Insistent

No basis for judgment

Work Habits Excellent Satisfactory Needs Improvement

Considering all of the above, I recommend this applicant for admission to Asociación Escuelas Lincoln:

With great enthusiasm With confidence With reservation

Check here if you would prefer to discuss this applicant over the phone : Yes No

Dr. Mr. Mrs. Ms.

Email:

Name:

Position:

School Name:

Signature: Date:

ASOCIACION ESCUELAS LINCOLN– Andrés Ferreyra 4073; B1637AOS La Lucila; Pcia. Bs. As., Argentina Telephone: 54-11-4851-1700 ext. 109 for Admission Registrar Fax: ext. 108 or 54-11-4851-1791

Email: admissions@lincoln.edu.ar Web: www.lincoln.edu.ar