Machaneches Form

Machaneches Form

Please share the following to the best of your knowledge. PLEASE NOTE that if necessary you can save your progress at the end of each page.
Machaneches Contact Details
Your Name:

First NameLast Name
Phone Number

Area CodePhone Number
Machaneches Email
Student Details
Name of student that you are referring:

First NameLast Name
Student Email
example@example.com
Relationship to student:
For how long do you know this student:
Number of years or months

	Excellent	Very Good	Good	Satisfactory	Poor
Respect for others
Positive attitude
Extends herself for others
Is sensitive to others
Stands up for what's right
Appearance and personal hygiene
Is honest & trustworthy
Is respectful of authority
Has yiras shomayim
Conducts herself with derech eretz
Follows rules
Emotional health

	Excellent	Very Good	Good	Satisfactory	Poor
Is involved in ongoing activities
Contributes & volunteers
Helpful and reliable
Careful with Tznius at all times
Adaptable & flexible
Capable of leading an event or program
Can work peacefully with others
Extends out of her group of friends

	Excellent	Very Good	Good	Satisfactory	Poor
Punctuality
Classroom participation
Interest in learning and growing
Grasps new concepts & ideas
Participation in class discussion
Attentivity in class
Completes assignments and schoolwork in a timely fashion

Machaneches Contact Details