CCK Teacher Recommendation Form

CCK Teacher Recommendation Form

2026-2027 (Please submit by January 29, 2026)
Child's Name

First NameLast Name
Teacher Name

First NameLast Name
Current School
Which of the following best describes this child? (Check all that apply)

ConfidentObservantCompletes tasks in a timely mannerEnjoys large motor activityShows self controlFollows multi-step directionsPatientUses words to resolve conflictCooperates with peers in the classroomInteracts well with peersSeparates from parents easilyEnjoys small motor activitiesSeeks help when neededAccepts responsibility for behaviorInteracts well with adultsAsks questions and participates in classTransitions easily between activitiesExhibits problem solving abilityCompletes tasks independentlyAble to verbalize wants and needsCan focus during large group instruction
Academic Assessment

Please fill out the information below to the best of your knowledge.
Shape/Color Recognition (choose one)

DevelopingAverageMastered
Letter Recognition
Knows _____ of 26 capital letters
Knows _____ of 26 lowercase letters
Number Recognition
Recognizes _____ numbers 1 - 10
Fine Motor Skills
Hand Dominance

RightLeft
Cutting Skills (choose one)

DevelopingAverageMastered
3-Finger Grasp of Writing Instruments (choose one)

DevelopingAverageMastered
Please share the individual strengths of this child. (Social, Emotional, Physical & Intellectual)
Please share some things that may prove difficult for this child. (Social, Emotional, Physical & Intellectual)
Please share any further comments you think will help better describe this child.
Thank you for your time in completing this Teacher Recommendation Form. If we have any further questions, we would like to be able to contact you. Please provide your contact information below.
Contact Information
Name

First NameLast Name
Email
example@example.com
Position
Phone Number
Please enter a valid phone number.
Should be Empty:

CCK Teacher Recommendation Form

Academic Assessment

Letter Recognition

Number Recognition

Fine Motor Skills

Contact Information