2013 AS&S Institutional Staff Recommendation Form Survey: Nepal

...................INSTITUTIONAL STAFF INFORMATION....................

For each recommended student, some of the fields in this section may have to be re-entered, e.g. School Name. In order to facilitate the process, consider using a text editor to contain the repeated information. Then use copy and paste to enter the repeated information into the appropriate fields.

* 2. School/College/University/Institute Name

* 3. Recommending Staff Member Name

* 6. Recommending Staff Member Email Address

* 7. Recommending Staff Member Phone Number

* 8. Recommending Staff Member Position

* 9. Recommending Staff Member Field and Subject of Research

* 10. Recommending Staff member affiliation to Research/Scholastic/Educational Society


Enter details regarding your recommendation of a student candidate. The recommended student will be referred to as "Candidate."

* 11. Candidate's Full Name

* 13. Candidates Email Address

* 14. Candidate's Age & Date of Birth(DOB) (in Yrs.)

* 19. Candidate's Grade Level/Rank/Class/Percentage of marks obtained in the current or last Exam/Assessment.

* 20. On what grade scale/ percentage out of?

* 23. List Advanced placement Level Courses taken by Candidate (If Applicable)

* 24. List talent and gifted programs Candidate is enrolled ( If Applicable)

* 25. Please use the 5-level rating scale to evaluate the student’s performance relative to other students with whom you have worked

  Below Average Average (Top 50%) Good (Top 25%) Excellent (Top 5%) Outstanding (Top 2%)
Factual Knowledge
Learns Information Quickly
Work Ethic/Accountability
Works well with peers
Class Attitude
Likes to solve difficult problems
Communication: Oral
Communication: written
Leadership Qualities
Research Interest
Academic Interest

* 27. Please Provide Candidate's and/ or Family's Citizenship Number

* 28. I certify that I have responded to the best of my understanding with respect to recommending the above-described candidate for membership in the Association of Science and Society(AS&S).

Please type the following text and your name as follows: I, (your name), have completed this form and agree to the above.

* 29. Date Completed

Please review all your responses before submitting your responses. Note: fields that MUST be answered (i.e. marked with an *) and fields with improper syntax, (e.g. emails without an @) will be flagged with explanatory text and submission will not go through until the flagged entries are corrected.
© MMX by Association of Science and Society(AS&S) and Harlem Children Society(HCS).
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