Dear Teacher,

The student referenced in the email is applying for admission to Angleton Christian School. Your evaluation of the student is an invaluable tool in the admission process. The applicant's file is not complete with out the completion of this form. Thank you in advance for your time and your comments.

*Please note that all information provided in this form is confidential and will not be shared with the student or parents. 

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* 1. Please provide the following information:

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* 2. Choose the response that best describes the social/emotional development of the student:

  Exceptional Above Average Average Fair Poor
Attention span
Ability to follow directions
Ability to complete tasks
Ability to work in groups
Attitude toward teachers
Attitude toward peers
Attitude of peers toward this child
Child is confident
Child has a sense of humor
Responds positively to correction
Cooperative

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* 3. Choose the response that best describes the school performance of the student:

  Exceptional Above Average Average Fair Poor
Works independently
Remains on task
Shows adequate fine motor skills
Grips pencil correctly

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* 4. Choose a response that best describes whole group observations of the student:

  Exceptional Above Average Average Fair Poor
Sits still, attentive, listens
Actively participates
Follows oral instructions

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* 5. Choose the response that best describes the parental support of the student and school:

  Exceptional Above Average Average Fair Poor
Family supports the child
Family supports the school 

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* 6. Concerns (check any that apply)

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* 7. General Observations

  Prefers to play alone Plays with others
Playtime

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* 8. General Observations

  Frequent Rare
Verbalization with peers 

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* 9. General Observations

  Needs encouragement to engage in class  Excited to engage in class
Class Involvement

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* 10. General Observations

  Hesitantly verbalizes Verbalizes confidently
Language usage

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* 11. Has or is the student receiving outside support? If yes, please explain. 

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* 12. Has this student been sent to the office for disciplinary problems? If yes, please explain. 

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* 13. Please include any additional comments: 

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* 14. Please include the following to serve as your electronic signature:

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100% of survey complete.

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