Application for Admission Request for Reference – Community Representative ______________________________________________________________________ Under the provisions of the Family Education Rights and Privacy Act of 1974, this applicant (if admitted and enrolled) will have access to the information provided below unless he/she waives such access. _____________________________________________________________________
To be completed by Applicant: 1. Name of Applicant __________________________________________ 2. Middle School ______________________________________________ 3. (Optional) I hereby waive my right of access to the material recorded below. __________________________________________________________________ Signature of Applicant Date
To be completed by Respondent:
I have known the applicant for approximately ______________ years. In the capacity of__________________________________________________________
In summary: Highly recommend Recommend Recommend with reservations Do not recommend
Respondent’s signature: ___________________________ Title ___________________ Date_________
Name Printed or typed:____________________________________________________ Address________________________________________________________________
To the Respondent: May we have your judgment of this candidate’s qualifications, and promise of the candidate’s intellectual ability, motivation, respect, responsibility and capacity for rigor. (You may use the back side of this sheet.) Please return this form to: Applicant in a sealed envelope. |