Confidential Teacher Evaluation Form 1st-5th Grade
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1
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3CONFIDENTIAL TEACHER EVALUATION FORM
1ST-5TH GRADE
TO BE FILLED OUT BY PARENT/LEGAL GUARDIAN OF CHILD
To Parent/Legal Guardian: Please deliver this form to your child’s teacher. The teacher will mail these forms directly to the Admissions Office.
By submitting this evaluation form and in consideration of having this evaluation and your application considered by Aurora Christian Schools,
you hereby release said member, its employees and representatives, the evaluator and the evaluator’s employer from any and all claims and
liability that may arise from the providing, obtaining or using the form and the substance of the information provided by the evaulator.
All information provided on the attached evaluation form will be held in the strictest confidence and will not be shared with students, parents or
guardians. This evaluation form will remain confidential.
Student’s Name _________________________________________________________________________________________________________
last (family) name
first (given) name
middle name
jr.,etc.
Applying for Grade ________________________________ Age level _______________
Male
Female
Student’s current school______________________________________________________________________________
Address of current school ______________________________________________________________________________
Telephone______________________________________________________________________________
Parent/Legal Guardian signature:________________________________________________________
Date:________________________
TO BE FILLED OUT BY TEACHER
Please fill out the following and if you would like to give additional information, please do so in the Comments section.
How long and in what capacity have you known the child? _______________________________________________________
Below, please evaluate the child in the following categories, in relation to other students you have worked with.
ACADEMICS
EXCELLENT
GOOD
FAIR
POOR/LIMITED
NO BASIS for JUDGEMENT
Critical/Abstract Thinking Skills
Intellectual Curiosity
Organizational Skills
Study Skills
Motivation
Determination
Creativity
Academic Potential
WORK SKILLS
: (please circle the response at right that best applies)
Class Participation
Joins in readily
Contributes occasionally Wants to dominate
Rarely contributes
Ability to work in a group
Consistently works well
Sometimes
Has difficulty
Has great difficulty
Ability to work independently
Consistently works well
Needs help occasionally Needs help frequently
Needs constant help
Completes assignments on time
Consistently on time
Usually on time
Needs additional time
Has difficulty
Follows directions
Easily and accurately
Occasionally needs help Needs much explanation Rarely
Takes initiative
Always
Usually
Sometimes
Rarely
Attention span
Actively engaged
Attentive
Variable attention
Requires frequent attention
Fine motor skills
Excellent
Good
Fair
Poor
Aurora Christian Schools - Grades 1-5 - Teacher Evaluation Form (1 of 3)
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