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Recommendation Form:
Elementary School Student
NOTE: This form is to be filled out by a school official
Student's First Name
Student's Middle Name
Student's Last Name
Language Arts Standardized Test Name:
Score:
*
Required
Minimal
Proficient
Advanced
Math Standardized Test Name:
Score:
*
Required
Minimal
Proficient
Advanced
If test score is unavailable, please explain why:
Language Arts performance?
*
Required
Mastery
Non-mastery
Math performance?
*
Required
Mastery
Non-mastery
Does the student have any learning disabilities?
*
Required
Yes
No
If so, please list each disability the student has:
How would you rate the student's academic potential and social skills?
*
Required
Outstanding
Excellent
Above Average
Average
Below Average
Do you believe the student will be academically successful while attending SR1 (Scientific Research) C.O.O.L Project: College Preparatory and STEM Training?
*
Required
Yes
No
How familiar are you with SR1 (Scientific Research)
*
Required
I am very familiar with SR1
I know something about SR1
I know very little about SR1
Has the student ever had any type of disciplinary issues (i.e. fighting, ISS, or suspension)?
*
Required
Yes
No
If so, please explain the student has:
Name of Recommender:
Phone
Email
Submit
Thanks for submitting!
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