Evaluation For High School Admission Page 4

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3. Does the student have any significant health problems or physical disabilities?
Yes
No
If yes, what:
4. Does the student have a diagnosed learning disability? Yes
No
5. Does the student have an IEP or a 504 Plan?
Yes
No
(If yes, a copy must be attached)
6. Are any type of educational accommodations made for this student? Yes
No
If yes, what:
7. Are there specific concerns (disciplinary, academic, or otherwise) about this student that you
would like to discuss by phone?
Yes
No
8. High school curricula offer both college preparatory programs for the student having ablility to
pursue a college diploma, as well as a general course of studies for those interested in preparation
for a career which does not require a college degree. For which type of program do you
recommend this student?
Honors_______ College Preparation
General Course
VI. Overall Evaluation
Below
Average
Good
Excellent Exceptional
Comments
As a young person
As a student
Name of Evaluator:
Contact Number:
Signature of Evaluator:
Position:
Date:
Please include the following documents:
th
1. Catholic Schools attach a copy of the 7
grade MAP Test results and a copy of the permanent
record card/transcript.
2. Public Schools attach a copy of the most recent standardized test results (percentile scores, if
possible) and a copy of the permanent record card/transcript.

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