Sample Teacher Reference Form

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TEACHER
REFERENCE FORM
CONFIDENTIAL REFERENCE FOR:
____________________________________
_______________________
_______________________
Student’s Last Name(s)
Student’s First Name
Student’s Preferred Name
The family of the student listed above has expressed interest in enrolling their child in Queen Margaret’s School. You have been selected as
a trusted academic reference for this applicant. If you do not feel well-equipped to offer a personal reference for this student, please forward
this form to another faculty member who may be able to offer a recommendation based upon a personal connection with this student.
Your candid and complete responses to the questions that follow are valuable in our assessment process. We are especially interested in
insights that may not appear in the student’s current reports but would serve their application and orientation. Your comments are held in
confidence.
Upon completion please email this confidential form directly to
admissions@qms.bc.ca
or fax to
(250) 746-4187.
Discover more about Queen Margaret’s School – Founded in 1921, Queen Margaret’s School is a university-preparatory high school for girls
(Grades 8 to 12), a boarding school for girls (Grades 6 to 12), a Junior School for boys and girls (Preschool to Grade 7), and Canada’s Equestrian
.
High School (optional program). Learn more about our programs and student life at
YOUR CONNECTION WITH THE STUDENT APPLICANT
______
______________________________________
I have known this student for
years in my capacity as:
(position)
____________________________________
_________________________________
Name of School:
City and Country:
This is a
Public School
Independent /Private School
IB School
Language School
Other:
________________________
STUDENT EVALUATION
Relative to other students of
An
An
Slightly
Minimally
Student
Unknown,
comparable age, I would place this
Exceptional
Excellent
Above
Meeting
Struggles
I have
student in the following category:
Candidate,
Candidate,
Average,
Expectations,
In This Area,
no Basis
Top 5%
Top 10%
Top 25%
Just Above 50%
Below 50%
for Judgment
O
O
O
O
O
O
Intellectual curiosity
O
O
O
O
O
O
Effort / Motivation
O
O
O
O
O
O
Academic potential
O
O
O
O
O
O
Academic achievement
O
O
O
O
O
O
Creativity
O
O
O
O
O
O
Organization
O
O
O
O
O
O
Responsibility
O
O
O
O
O
O
Confidence
O
O
O
O
O
O
Maturity (relative to age)
O
O
O
O
O
O
Honesty / Integrity
O
O
O
O
O
O
Sense of humour
O
O
O
O
O
O
Class participation
O
O
O
O
O
O
Ability to work independently
O
O
O
O
O
O
Ability to work with others
O
O
O
O
O
O
Concern for others
O
O
O
O
O
O
Respect for others
O
O
O
O
O
O
Cultural acceptance
O
O
O
O
O
O
Social interactions with peers
O
O
O
O
O
O
Respect from peers

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