Lake Zurich High School PE Leader Program
Recommendation Form
Congratulations! You have been honorably selected to fill out a student
recommendation form for admittance into the PE Leader Program.
The physical education department is currently taking applications for
prospective sophomore candidates that aspire to be a part of the two-year
junior/senior leader program in physical education.
The leader program is designed to teach and implement Strategic Core Values and
Objectives as a means to promote positive student achievement. Through a
comprehensive curriculum of team building and cooperative based learning strategies,
students will have an opportunity to explore leadership roles, build positive, respectful
relationships with peers and teachers and exemplify characteristics of an outstanding
citizen. By demonstrating skills, leading large and small groups in activity and acquiring
knowledge related to the field of physical education, students will cultivate an interest in
leader based professions. The overall goal of the PE Leader Program is to provide
opportunities for leadership development in our students within a physical
education environment.
The method of application and selection into the program requires that each
candidate be evaluated by a teacher/sponsor. The comments and input you
provide will help insure that the top students with leadership potential get
selected to be a part of the program.
Please take the time to fill out the evaluation on the reverse side. All
recommendation forms are confidential and will not be seen by the
applicant. Any additional comments you would like to make that might
provide insight into the leadership potential of this candidate would be
greatly appreciated.
* Completed recommendation forms are to be returned to my mailbox by no
later than Friday, February 19th 2016.
Thanks for giving up some of your valuable time to benefit the physical
education department. If you have any questions concerning this form,
please don’t hesitate to contact me at ext. 5463 or email me at
michelle.levin@lz95.org.
Sincerely,
Michelle Levin
PE Leader Program Coordinator
** Please return this form to Ms. Levin’s mailbox by Friday, February 19th
Lake Zurich High School PE Leader Program Recommendation Form
Name of Applicant: _______________________ ID# ____________________
Recommending Teacher/Sponsor/Coach: _________________ Signature: ____________
Use the following descriptions to rate the prospective applicant:
1. Academic Work Ethic – Displays a high level of effort and accountability; strives to improve.
2. Assertiveness – Self-confident and self-assured; steps up and takes initiative when directing others.
3. Communication Skills – Proficient public speaker; speaks with purpose and strength of voice.
4. Integrity – Honest and trustworthy; displays a high level of respect for school and self.
5. Consideration for Others – Empathetic and patient; enjoys helping others and providing service.
6. Problem Solving Skills – Able to think quickly on one’s feet; adapts creatively to adversity.
7. Time Management – Multitasks and takes risks; tackles multiple activities with confidence.
8. Relationship with Adults – Communicates respectfully and honestly; follows directions.
9. Relationship with Peers – Well respected and admired by peers; leads by example.
10. Teachability - Able and willing to learn in diverse environments; responds well to criticism.
Rank the students in the following categories with 1 being the lowest and 4 being the
highest. A score of 4 is extremely difficult to receive. Consider giving a 4 only when
this student demonstrates unwavering commitment to the behavior trait.
LOW
HIGH
(Very little) (Sometimes)
(Almost always)
(Without fail)
Academic Work Ethic
1
2
3
4
Assertiveness
1
2
3
4
Communication Skills
1
2
3
4
Integrity
1
2
3
4
Consideration for Others
1
2
3
4
Problem Solving Skills
1
2
3
4
Time Management
1
2
3
4
Relationship with Adults
1
2
3
4
Relationship with Peers
1
2
3
4
Teachability
1
2
3
4
Comments on overall leadership potential: _____________________________________
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