Form B – Recommendation Form
Technion International
For Applicant:
Please submit a recommendation from a teacher who is familiar with your academic capabilities.
For Evaluator:
Please fill out the following form.
You can send the complete form and via e-mail to admissions@int.technion.ac.il or enclose it in an
envelope and sign your name over the flap of the sealed envelope. Please give the envelope to the
applicant.
1. Background information:
Name of Applicant: ______________________________________________________________________
Name of Evaluator: ______________________________________________________________________
Relationship to the applicant: _____________________________________________________________
Length of acquaintance: _____Years
______Months
I have been teaching for _____Years
2. What do you feel are the applicant’s talents and/or strengths referring to the following aspects?
Academic: _____________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------------------------------Social: ________________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------------------------------Personal: ______________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------------------------------Other: ________________________________________________________________________________
______________________________________________________________________________________
3. What do you feel are the weaknesses of the applicant referring to the following aspects?
Academic: _____________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------------------------------Social: ________________________________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------------------
Personal: ______________________________________________________________________________
--------------------------------------------------------------------------------------------------------------------------------------------Other: ________________________________________________________________________________
______________________________________________________________________________________
4. How do you describe his/her ability to make friends and get along and cooperate with others?
______________________________________________________________________________________
______________________________________________________________________________________
5. How does the applicant handle stressful situations?
______________________________________________________________________________________
______________________________________________________________________________________
6. How do you describe the applicant’s motivation for advance studies?
______________________________________________________________________________________
______________________________________________________________________________________
7. Do you know of any personal circumstances which might affect the applicant’s studies?
______________________________________________________________________________________
______________________________________________________________________________________
8. Extracurricular and/or community activities?
______________________________________________________________________________________
______________________________________________________________________________________
9. Please rate the applicant referring to the items listed below:
weak
fair
good very good Excellent
not known
lower 50% top 50% top 25% top 15% top 5%
Intellectual potential
Academic performance
Ability to succeed with an advanced
academic level of mathematics
Ability to succeed in an advanced
academic studies of physics
English skill
Ability to analyse/ problem solve
Creativity and imagination
Motivation for advance study
Independence and maturity
Ability to adapt to a new
environment
10. Please rank this applicant among his/her peer group, to the best of your observation:
 Outstanding, among the best I have known
 Excellent, stands out in peer group
 Successful as Average
 Below Average
11. Please indicate your overall evaluation of the applicant:
Strongly recommended Recommended Recommended with reservation Not recommended
Name_________________________________________________________________________________
Title________________________________ E-mail _____________________________________________
Name of school _________________________________________________________________________
Address: _______________________________________________________________________________
City ________________________________ State ____________________________________________
Zip Code ____________________ Country __________________________________________________
Telephone Number of School: Country Code ______Area Code ______Number _____________________
Signature _________________________________ Date _______________________________________