Online Teacher Recommendation Form

Required information is shown in red

School Information

Name of School:

Address of School

Address Line 1:

Address Line 2:

City: State/Province:

Country:

Student Information

Name of Student:

Grade: Age:

Number of years of study of English Language:

Student Background

Any English speaking background:

Course(s) followed:

Certificates achieved:

Time spent in any English speaking country - list the country and the time spent:

Country 1: Time spent:

Country 2: Time spent:

Country 3: Time spent:

Proficiency level reached:
Fluent / near fluent
Communicates easily in familiar situations
Makes himself/herself understood
Struggles to communicate in basic expressions
A near beginner

Student Personality

Relationships with peers	No basis for judgement Average Below Average Above Average Excellent
Co-operation	No basis for judgement Average Below Average Above Average Excellent
Level of maturity	No basis for judgement Average Below Average Above Average Excellent
Leadership qualities	No basis for judgement Average Below Average Above Average Excellent
Work habits and organization	No basis for judgement Average Below Average Above Average Excellent
Self-discipline	No basis for judgement Average Below Average Above Average Excellent
Concern for others	No basis for judgement Average Below Average Above Average Excellent
Response to criticism	No basis for judgement Average Below Average Above Average Excellent
Dependability	No basis for judgement Average Below Average Above Average Excellent
Self-confidence	No basis for judgement Average Below Average Above Average Excellent
Ability to work independently	No basis for judgement Average Below Average Above Average Excellent
Personal motivation	No basis for judgement Average Below Average Above Average Excellent
Fulfilment of potential	No basis for judgement Average Below Average Above Average Excellent

Has this student been involved in any disciplinary procedure? Please explain:

Special Notes

Special Notes:

Teacher's Name:

Your E-mail:

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