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* 1. Teacher Name and Email Address:

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* 2. Student First Name

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* 3. Student Last Name

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* 4. Compared to other students, how do you rate this student in terms of:

  Below Average Average Good Very Good Excellent One of Top Few
Academic Achievement:
Extracurricular Accomplishments:
Personal Qualities and Character:
Works Well Independently
Works Well in Small Groups
Works Well in Large Groups
Overall:

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* 6. Classes with:

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* 7. How long have you know this student and in what context?

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* 8. Please add any additional comments you would like to share with the selection committee.

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