Application - Our Lady of Good Counsel High School

Do not submit this form if you are in a Washington Archdiocese Catholic Elementary School.Math TeacherRecommendation FormThe purpose of this form is to request a general assessment of the student, which will become part of his/herapplication for admission to Good Counsel High School. The contents of this assessment are confidential andare not routinely shared with applicants and their families, though all educational records are subject to theFamily Educational Rights and Privacy Act of 1974. Applicants’ records only become permanent if theymatriculate at Good Counsel.APPLICANT’S LEGAL NAME LAST FIRST MIDDLECURRENT SCHOOLSCHOOL PHONEEVALUATOR’S NAMEPOSITIONEVALUATOR’S SIGNATUREDATEEvaluator – Compared to other students whom you have taught or advised, please assess this student for thefollowing characteristics. Please mail or fax the completed form to the address below.Key:1 = outstanding2 = good3 = satisfactory4 = improvementneeded5 = unsatisfactoryN = not observedAbility to work independentlyAbility to work in a groupAbility to follow directionsAchievement related to potentialOrganization of time and workSelf-motivationConductIntegrityLeadershipEmotional MaturityRelationship with peersRelationship with adultsConcern for othersSelf confidence1 2 3 4 5 NIncoming Freshman deadline: December 11, 2009Transfer Student deadline: April 15, 2009 for the 2009-2010 school yearParents, please include a self-addressed stamped envelope with the registration form.17301 Old Vic Boulevard, Olney, MD 20832Phone: 240-283-3235 Fax: 240-283-3250INCOMING FRESHMAN/TRANSFER