U.S. University Readiness Program 2021 Teacher Recommendation Form

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* 1. School name

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* 2. Name of counselor or teacher

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* 3. Position

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* 4. Contact information

Counselor/Teacher phone

Counselor/Teacher email

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* 5. Student full name as it appears on his/her Emirates ID and/or passport

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* 6. Student Emirates ID and/or passport number

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* 7. Student Current Grade Level:

 Grade 11

 Other

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* 8. Student’s grade 9 secondary school letter grade

 A (90 - 100)

 B (80- 89.99)

 C (70- 79.99)

 D (60- 69.99)

 E (50- 59.99)

 F (0- 49.99)

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* 9. Student’s grad 10 secondary school letter grade

 A (90 - 100)

 B (80- 89.99)

 C (70- 79.99)

 D (60- 69.99)

 E (50- 59.99)

 F (0- 49.99)

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* 10. Has the student had any disciplinary problems at school or in the community?

Yes

If yes, please explain

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* 11. Does the student have any special educational needs (i.e. as a result of dyslexia, physical or mental disabilities)?

Yes

If yes, please explain

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* 12. Please rate the student on the criteria below.
Please use the 1 – 5 scale to give your assessment of the student for each statement. (1 = poor 2 = fair 3 = good 4 = very good 5 = excellent)

	Poor	Fair	Good	Very good	Excellent
Demonstrates strong motivation to learn	Demonstrates strong motivation to learn Poor	Demonstrates strong motivation to learn Fair	Demonstrates strong motivation to learn Good	Demonstrates strong motivation to learn Very good	Demonstrates strong motivation to learn Excellent
Has consistent attendance at school	Has consistent attendance at school Poor	Has consistent attendance at school Fair	Has consistent attendance at school Good	Has consistent attendance at school Very good	Has consistent attendance at school Excellent
Actively participates in class and contributes to discussions	Actively participates in class and contributes to discussions Poor	Actively participates in class and contributes to discussions Fair	Actively participates in class and contributes to discussions Good	Actively participates in class and contributes to discussions Very good	Actively participates in class and contributes to discussions Excellent
Completes school assignments in a timely manner	Completes school assignments in a timely manner Poor	Completes school assignments in a timely manner Fair	Completes school assignments in a timely manner Good	Completes school assignments in a timely manner Very good	Completes school assignments in a timely manner Excellent
Works collaboratively with classmates on assignments and projects	Works collaboratively with classmates on assignments and projects Poor	Works collaboratively with classmates on assignments and projects Fair	Works collaboratively with classmates on assignments and projects Good	Works collaboratively with classmates on assignments and projects Very good	Works collaboratively with classmates on assignments and projects Excellent
Demonstrates independent study skills	Demonstrates independent study skills Poor	Demonstrates independent study skills Fair	Demonstrates independent study skills Good	Demonstrates independent study skills Very good	Demonstrates independent study skills Excellent
Participates in extracurricular or community activities	Participates in extracurricular or community activities Poor	Participates in extracurricular or community activities Fair	Participates in extracurricular or community activities Good	Participates in extracurricular or community activities Very good	Participates in extracurricular or community activities Excellent
Demonstrates an interest in pursuing higher education	Demonstrates an interest in pursuing higher education Poor	Demonstrates an interest in pursuing higher education Fair	Demonstrates an interest in pursuing higher education Good	Demonstrates an interest in pursuing higher education Very good	Demonstrates an interest in pursuing higher education Excellent

U.S. University Readiness Program 2021 Teacher Recommendation Form

Question Title

* 1. School name

Question Title

* 2. Name of counselor or teacher

Question Title

* 3. Position

Question Title

* 4. Contact information

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* 5. Student full name as it appears on his/her Emirates ID and/or passport

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* 6. Student Emirates ID and/or passport number

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* 7. Student Current Grade Level:

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* 8. Student’s grade 9 secondary school letter grade

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* 9. Student’s grad 10 secondary school letter grade

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* 10. Has the student had any disciplinary problems at school or in the community?

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* 11. Does the student have any special educational needs (i.e. as a result of dyslexia, physical or mental disabilities)?

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* 12. Please rate the student on the criteria below. Please use the 1 – 5 scale to give your assessment of the student for each statement. (1 = poor 2 = fair 3 = good 4 = very good 5 = excellent)

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* 13. Additional Comments (optional)

* 12. Please rate the student on the criteria below.
Please use the 1 – 5 scale to give your assessment of the student for each statement. (1 = poor 2 = fair 3 = good 4 = very good 5 = excellent)