Kindergarten Student Recommendation Form

Teacher's Name*

First NameLast Name

Position*

Student Name*

First NameLast Name

Relationship to Student*

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

School Name*

Physical Development*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent(Top %10)
Fine Motor Coordination
Gross Motor Coordination
Participates in Group Physical Activities

Social Emotional Development*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent(Top %10)
Accepts Change
Accepts Limits
Appropriately Assertive
Works on Tasks Independently
Liked by Other Children
Ability to Share
Resolves Conflicts Verbally
Uses Appropriate Language
Capacity to Lead
Capacity to Follow
Cooperation in Class Work/Projects
Sense of Humor
Makes Transitions Easily
Initiates Easily
Cooperation in Play
Separates from Adult Caregivers
Interaction with Adults
Comfort in Small Group
Comfort Alone
Comfort in Large Group
Demonstrates Self Control
Awareness of Personal Space
Ability to Utilize Age Appropriate Behavior
Ability to Self-Regulate
Easily Tolerates a Variety of Sensory Stimuli
Ability to Follow Classroom Routine

Intellectual Development*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent(Top %10)
Follows Directions
Understands Stories Read Aloud
Understands Classroom Discussion
Ability to Listen in a Small Group
Contribution to Discussion
Ability to Follow 1-Step Directive
Speaks Clearly
Expresses Self Fluently
Active Vocabulary
Tells Story Events in Sequence
Uses Logical Reasoning
Shows Creativity in Thought and Work

Reading Skills - English*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent
Recognizes Letter Names
Recognizes Letter Sounds
Passive Vocabulary
Recognizes Whole Words

Reading Skills - Hebrew*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent
Recognizes Letter Names
Recognizes Letter Sounds

Math Literacy*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent
Recognizes Numerals
Understands One-to-one Correspondence
Patterning
Categorizing
Sequencing
Recognizes Shapes

What are the Candidate's Strengths as a Student? (Specific Areas)*

What are the Candidate's Areas of Challenges as a Person? (Specific Areas)*

What are the Candidate's Areas of Challenges as a Student? (Specific Areas)*

What are the Candidate's Strengths as a Person? (Specific Areas)*

Has the student ever been recommended for any of the following special programs or interventions:*

Rows	No Basis for Judgement	Below Average	Average	Above Average	Excellent
Gifted
Behavioral Therapy
Academic Support
Speech
Counseling
Psycho-Ed Evaluation
Occupational Therapy

Please write a summary statement assessing the candidate's quality and promise as a participant in a rigorous academic program and environment. Include- character, relative maturity, values and special interests or talents. If the candidate's record is not a true index of ability, please explain factors which have interfered with his/her academic achievement*

Teacher's signature:*

Student Recommendation Form

Additional Information