Student Feedback Form printable pdf download

Student Feedback Form

STUDENT FEEDBACK FORM

This form is intended to be filled out by a TEACHER and returned to the counselor. The information

provided below may be used by the counselor for recommendations/college applications.

STUDENT______________________________________TEACHER_______________________

SUBJECT TAUGHT_____________________________ fr so jr sr (circle year taught)

1. What are the first word that come to mind to describe the student:

As a person:

As a student in your class:

As a member of your high school community:

2. Please check the item(s) that most appropriately describe this student:

a. Participation in discussion (self-initiated)

____ always involved, often initiates discussion

____ usually participates

____ often participates

____ occasionally participates

____ not applicable

b. Involvement in classroom activities

____ actively participates in all activities

____ active, usually shows genuine interest

____ mild, politely attentive

____ languid, attention often wanders

____ distracted, does other things during class

____ attention and focus varies greatly

c. Pursuit of independent study

____ considerable study and major project(s)

____ considerable study or major project(s)

____ some study and minor project(s)

____ no evidence of independent study

____ not applicable

d. Consistency of performance

____ exceptionally consistent

____ even, varies no more than one grade

____ slightly uneven, often varies by one grade

____ uneven, often varies two grades

____ erratic performance, fluctuates greatly

e. Critical and questioning attitude

____ often challenges

____ sometimes challenges

____ occasionally is skeptical

____ sometimes probes

____ rarely questions

____not applicable

(OVER)

Student Feedback Form