The American International School of Bamako
c/o U.S. Embassy, BP. 34, Bamako, Mali
Tel: (223) 222 47 38 | Fax: (223) 222 08 53 | aisb@aisbmali.org |www.aisbmali.org
CONFIDENTIAL SCHOOL REPORT FORM
TEL: 223 – 2022-4738
Fax: 223- 2022- 0853
Email: registrar@aisbmali.org
(To be completed by divisional principal or designated official)
STUDENT’S NAME:
/
/
Last
DATE OF BIRTH:
/
Month
First
Other
/
Day
Year
CURRENT GRADE LEVEL:
NUMBER OF YEARS AT CURRENT SCHOOL:
This student is applying to AISB, a private, not for profit, co-educational, college preparatory, international school. AISB
is committed to educating students from diverse cultures to achieve academic excellence. The program of studies is
designed to challenge the average to above average student in grades PK-12. 100% of our graduates attend university. In
order to determine whether the student is likely to be successful at our school, your recommendation is vital to our process
and is completely confidential – we will not share it with the student’s family. We would appreciate your most candid and
thoughtful responses. Please complete this form and return it in a sealed envelope to the Registrar or email to
registrar@aisbmali.org.
1.
Please complete the following questionnaire:
 Learning potential:
Select one option
 Creativity:
Select one option
 Ability to maintain focus:
Select one option
 Organizational ability:
Select one option
 Persistence:
Select one option
 Emotional stability:
Select one option
 Self – confidence:
Select one option
 Ability to get on with others:
Select one option
 Responsibility:
Select one option
 Concern for others:
Select one option
 Participation in activities:
Select one option
 Leadership qualities:
Select one option
 General behavior:
Select one option
 Sense of humor:
Select one option
 Ability to work independently:
Select one option
2.
What are the student’s greatest strengths?
3.
What are the student’s greatest challenges?
4.
To your knowledge, has the student ever repeated a grade?
Yes
No
If yes, please provide details.
Page 1 of 2
Updated January 2014
5.
Does the student possess any diagnosed learning disability?
(If yes, check all that apply and provide details)
ADD/ADHD
Dyslexia
Yes
No
Speech/Language Development
Sensory or Motor development
Other
Please provide details:
Note: AISB does have a special needs program, but can only meet the needs of students with mild learning difficulties.
6.
Has an educational or behavior assessment ever been recommended?
7.
Has the student been recommended for or involved in Individual or group counseling?
8.
Please list extracurricular activities in which the student is, or has been involved. (Sports, music, drama, committees,
etc.)
9.
Please describe this family’s involvement in their child’s education.
Name of Official:
Yes
No
Yes
No
Position:
Name of School:
City:
Country:
Tel:
Fax:
Email:
Date:
Page 2 of 2
Signature:
Updated January 2014