Miraaj Student Reference Form

Student Reference Form

Choose one reference to complete this form. Please choose a reference that is not family members and over the age of 18.
Your Name: *

First Name Last Name
Email *
example@example.com
Phone Number

Area Code Phone Number
Students First & Last Name *
Relationship to Student: *
How long have you known him/her? *

Please check off the best answer: *

	Top Student	Above Average	Average	Below Average	No Basis for Evaluation
Community Service/Involvement
Academic Achievement
Intellectual Curiosity
Determination/Motivation
Memorization of Quran
Islamic Studies
Leadership Ability
Concern for Others
Honesty/Integrity
Maturity (relative to age)
Responsibility
Show respect for elders
Show respect for peers
Emotional stability
Overall personal character
Overall student performance

Please add any information that will give us a complete picture of this student
Thank you for taking valuable time to complete this reference form. Your feedback is an important part of the admissions process
Signature
Should be Empty: