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Independent Schools of the San Francisco Bay Area

Common Confidential Student Evaluation Form (2

- 8

Grade Applicants)

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

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

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