AISR Confidential Student Report: Admissions & Placement

AISR Confidential Student Report To the sending school: This is a CONFIDENTIAL report. Please do not send a copy to the family or student. Please send this report directly to the email address at the bottom of page 3. Thank you in advance for filling out this Confidential Student Report which AISR uses for both admissions and placement purposes. We ask that the person filling out this form complete the information to the best of his/her ability plus gather information from relevant colleagues. Name of student: ____________________________________________ Current grade/year:___________ Name of the person(s) completing this form: __________________________________________________ Title/role (check all that are relevant): administrator counselor teacher and teaching area:_____________________ other (please specify) ___________________________________________________________________ How long and in what capacity have you known the applicant> ___________________________________ _______________________________________________________________________________________ Name and address of the school: ____________________________________________________________ _______________________________________________________________________________________ Please indicate below your assessment of the student’s Academic Qualities and Personal Attributes. Academic Qualities Overall Academic Achievement Overall Academic Potential Effort and Motivation Organization Far above expectations Better than expected As expected Below expectations Outstanding Good Average Below average Outstanding Good Occasional Inconsistent Well organized Organized Rarely organized Ability to work with others Ability to work independently Always works cooperatively Works well independently Rarely cooperates with others Requires constant supervision Oral expression of ideas Demonstrates positive oral expression Beyond grade level Usually works cooperatively Needs some support to work independently Good Sometimes organized Sometimes works cooperatively Rarely works independently Only when asked to speak Wants to dominate At grade level Approaching grade level Below grade level Understands text at a basic level Has difficulty understanding what he/she has read Reading (decoding) Reading comprehension Has high level comprehension skills Rarely contributes Academic Qualities (cont.) Writing skills Strong written expression Good written expression Unable to express self in writing Good Needs support to express self in writing Below average Mathematical Ability Seeks help when needed Concentration Strong Always Usually Sometimes Rarely Exceptional Usually good Occasionally distracted Easily distracted Integrity Very trustworthy Interacts with adults and students comfortably and appropriately Always considerate Actively involved in a positive way Has healthy self-image Occasionally trustworthy Isolates self from others Untrustworthy Social skills Usually trustworthy Lacks maturity in social interaction (relative to age) Usually considerate Cooperative Rarely considerate Uninvolved Selfish Overly protective Needs some support Appears overly self-confident Needs much reassurance Weak No basis for judgment Personal Attributes Consideration for others Attitude of parents Self-confidence No basis for judgment Antagonistic/ difficult No basis for judgment Please comment upon any areas needing growth: What support services has the applicant previously received, or is he/she presently receiving? behavior management ESL/ELL/EAL/ESOL speech/language therapy remedial help occupational therapy learning support/ SEN individual/family counseling other: Please comment on the services received: IEP/ILP none For Secondary Applicants Only (entering grades 6-12) Student’s mathematical background: Please check the courses which the student will have completed by the end of the school year. Pre-Algebra 1st Year Algebra Geometry 2nd Year Algebra w/ Trig Pre-Calculus IB Math Studies IB Standard Level IB Higher Level Integrated Math What textbook(s) is/are used in the student’s course? ___________________________________________ _______________________________________________________________________________________ If the student were to remain at your school, which course would you be recommending for next year? _______________________________________________________________________________________ Thank you for your help and time. We ask for your email address below in the event we may need to follow up and ask for additional information. _____________________________________ Signature __________________ Date ___________________________ Email Address Please scan this form and return it to Mrs. Aurora George-Kelso, AISR Admissions Officer, aurora.george-kelso@aisr.nl

AISR Confidential Student Report: Admissions & Placement

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