EmailMe Form - Teacher Referral - Middle School (5th-8th)

TO THE PARENT:

Please send the link to this form to the student's Math or English teacher to fill out.

The referral form MUST be filled out by the teacher and come from the teacher's email address and not from the parent's.

Student's Name *

First Last

Student's Current School *

Student is applying for

5th grade

6th grade

7th grade

8th grade

School's Phone

### - ### - ####

TO THE TEACHER:

The student listed above is applying for admission to Northlake Christian
School in Covington, Louisiana. Northlake Christian School is a non-denominational coeducational Christian school with a college-preparatory emphasis.

The school seeks to enroll students who have demonstrated potential for academic success, integrity, good citizenship and spiritual sensitivity.

Because you are someone who knows the applicant well, we appreciate your thorough, candid appraisal. This confidential form, along with other items of assessment, will be used by the Admissions Office in evaluating the applicant. Thank you for taking the time to complete this form.

Also, we appreciate your promptness as there are admission deadlines approaching.

Parents will not see the results of this form but it will emailed directly to Northlake Christian School Admissions.

Name of Teacher Completing this form *

First Last

Teacher's Email (in case we have further questions)

For how long have you known this applicant? *

What words immediately come to mind concerning this student: *

What words immediately come to mind concerning this family’s cooperation and involvement with school? *

What subject have you most recently taught this applicant?

What is the applicant’s current grade point average in your class? *

Academic Skills

Please circle the numbers that best represent the student. We welcome your comments.

Evaluate the following statements.

	Outstanding	Very Good	Good	Fair	Poor	No Opportunity to observe
General Reading Ability	1	2	3	4	5	6
Word Attack Skills	1	2	3	4	5	6
Reading Comprehension	1	2	3	4	5	6
Creative Writing Skills	1	2	3	4	5	6
Spelling Skills	1	2	3	4	5	6
General Math Ability	1	2	3	4	5	6
Computation Skills	1	2	3	4	5	6

Additional Comments

Who is the publisher of your Reading program?

Who is the publisher of your Math program?

Social Development/Work Habits

Please circle the numbers that best represent the student. We welcome your comments.

Evaluate the following statements.

	Usually	Sometimes	Seldom	No Opportunity to Observe
Is attentive	1	2	3	4
Able to focus on one task	1	2	3	4
Follows Directions	1	2	3	4
Completes tasks in a timely manner	1	2	3	4
Works independently	1	2	3	4
Is a self starter	1	2	3	4
is organized	1	2	3	4
Relates positively with adults	1	2	3	4
Works well with peers	1	2	3	4
Respects classroom routines	1	2	3	4
Is courteous/considerate of others	1	2	3	4

Additional Comments

Please use the following scale in your recommendation of the applicant.

Has the applicant been recommended/evaluated for any special services? (Speech therapy, etc?)

Description of applicant (Please include outstanding qualities, as well as other areas which indicate a need for further development)

Recommendation for the upcoming school year: Please describe how you would assess the applicant's ability to succeed in a structured, academically challenging educational program.

Choose one and include any additional comments. *

I recommend this student: *

Any additional Comments we need to know about this student:

Thank you so much for taking the time to complete this form. Your assistance helps us immensely!

This form will be emailed directly to the Office of Admissions at Northlake Christian School.