Teacher Recommendation

Student's Full Name

First Name

Last Name

Teacher's Name *

First Name

Last Name

Phone Number

(###)

###

####

Today's Date *

MM

DD

YYYY

Attends school on a regular basis

1

2

3

4

5

Arrives to school on time

1

2

3

4

5

Completes class assignments on time

1

2

3

4

5

Displays school pride

1

2

3

4

5

Respects and honors school environment

1

2

3

4

5

Shows positive attitude in class

1

2

3

4

5

Gets along well with others

1

2

3

4

5

Demonstrates eagerness and capacity to learn

1

2

3

4

5

Engages in school activities

1

2

3

4

5

Shows ability to make and keep commitments

1

2

3

4

5

Receptive to new ideas

1

2

3

4

5

Accepts responsibility

1

2

3

4

5

Demonstrates initiative

1

2

3

4

5

In what other areas could the student use help from a mentor? Check all that apply and add your comments:

Time management

Organizational skills

Interpersonal skills

Leadership skills

Communication skills

Job related skills

Other