Recommendation for Admission to Upper Division
of Teacher Education in Mathematics Education
NAME OF APPLICANT: _______________________________________________________________________
(Last)
(First)
(Middle)
NAME OF REFERENCE: ______________________________________________________________________
COURSE(S) AND SEMESTER(S) IN WHICH APPLICANT HAD INSTRUCTOR:
___________________________________________________________________________________________
TO THE REFERENCE: In order to be admitted to the Upper Division of Teacher Education in Mathematics, a
student needs recommendations from faculty members who can write about his/her potential. In the rating scales
below, please check, after each trait to be evaluated, that column which most nearly represents your opinion of the
student above. In order that you may recognize the applicant, I am asking that the student present this form to you in
person. If you do not remember this student please interview him/her to refresh your memory so the evaluation may
be as accurate as possible. If more space for comment is required, please continue on the back of this form. Please
return this form to the Mathematics, Science, and Instructional Technology Education office in Flanagan 342 (in
person or by campus mail). Do not return to student, unless in signed and sealed envelope.
Note: The family educational rights and privacy act of 1974 gives students full access to their official records after
January 1, 1975, unless the student waives right of access to confidential recommendations. Waiver is hereby
indicated by student's signature below.
STUDENT'S SIGNATURE ______________________________________________________________________
NOTE: A typical group of 100 students might be expected to be divided approximately as indicated in the chart.
Please rate the student accordingly.
Below
Average
Lowest 40%
Average
Middle 20%
Somewhat
Above Average
Next 20%
Very Good
Outstanding
Next 10%
Highest 10%
1. Degree of mastery in
course taken with you is
2. Ability to express thoughts
in speech and writing is
3. Dependability is
4. General appearance and
personality are
5. Growth during the period
you have know student is
6. At present does the student, in your opinion, have the qualifications necessary for continuing in the teacher
education program in mathematics education? ________________________________________________________
7. Additional remarks: ___________________________________________________________________________
_____________________________________________________________________________________________
Date: _______________________
Respondent: _______________________________________________