Ketchikan•Gero•Kanayama Student Recommendation Question Title * 1. Student Name: Name: The above student is applying to be a part of the Ketchikan-Kanayama Student Exchange. He/She would like your evaluation of how you think he/she will fit in with the group traveling. This information will be treated as CONFIDENTIAL and not shared with parent or student. Please answer honestly. Thank you for your help in the selection process. Question Title * 2. How long have you known this applicant? Question Title * 3. In what capacity? Teacher Family Friend Coach Other Question Title * 4. What characteristics or attributes best describe this applicant? Question Title * 5. In what area(s) is this student most exceptional? Question Title * 6. How well do you feel the student participates within a group? Very Well Well OK Not Well Question Title * 7. How well does this student communicate with others (peers, adults, etc.)? Very Well Well OK Not Well Question Title * 8. Is this student trustworthy? Yes No Question Title * 9. Comment on how the student is trustworthy: Question Title * 10. Does this student respect authority? Yes No Question Title * 11. Comment on how the student respects authority: Question Title * 12. How well does this student tolerate difference and respect others within his / her peer group? Very Well Well OK Not Well Question Title * 13. Comment on how well the student tolerates differences and respects others in his/her peer group: Question Title * 14. Is this student reliable and prompt? Yes No Question Title * 15. Does this student possess leadership skills? Yes No Question Title * 16. Does this student make his/her own decisions despite obvious peer pressure? Yes No Most of the time Question Title * 17. Comment on how this student makes his/her own decisions despite peer pressure. Question Title * 18. Would you have any reservations if you were accompanying this student on an extended trip to a foreign country? Yes No Some Reservations Question Title * 19. Comment on reservations if yes or some is checked. Question Title * 20. How would this student react if he/she were put in the spotlight? Question Title * 21. Please make any other comments about your general impression of the applicant. Question Title * 22. Your Name: Name: Email Address: Phone Number: Thank your for your time. Your comments will help us as we make our selections for current travel group. All responses are confidential. Done