Fillable Student Recommendation Excursions in Learning

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Student Recommendation Excursions in Learning

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Excursions in Learning
Student Recommendation
REQUIRED ONLY FOR NEW STUDENTS APPLYING TO THE SUMMER ACADEMY FOR GIFTED AND TALENTED YOUTH.
To be completed by the student’s classroom teacher or school counselor and sent to Linda Armstrong, Excursions in Learning,MS #16, Manchester Community College, P.O. Box 1046, Manchester,
CT 06045-1046; or fax form to 860-512-2801; or scan form and email to larmstrong@manchestercc.edu. This form can also be completed and submitted online at https://www.manchestercc.edu/
excursions/StudentRecForm. For more information, contact Linda Armstrong at 860-512-2804 or larmstrong@manchestercc.edu.
INFORMATION
Student First Name MI Last Name Grade
Parent/Guardian Name Email
Teacher/Counselor Completing Form Name Position/Title
Teacher/Counselor Email School Name
STUDENT BACKGROUND
Does this student participate in a gifted and talented program in his/her school district?
n
Yes
n
No
n
No formal gifted program offered
If yes, name program
In what subject areas does this student show strength and interest?
Will this student be able to successfully participate and focus for a three-hour class? Please explain:
STUDENT ASSESSMENT
Student’s Ability
n
Average
n
Above Average
n
Superior
n
Other
If other, please explain (use separate paper if needed)
Student’s Focus
n
Average
n
Above Average
n
Superior
n
Other
If other, please explain (use separate paper if needed)
Student’s Motivation
n
Average
n
Above Average
n
Superior
n
Other
If other, please explain (use separate paper if needed)
This student is kind and considerate to others: This student is respectful to others:
n
Never
n
Rarely
n
Sometimes
n
Frequently
n
Always
n
Never
n
Rarely
n
Sometimes
n
Frequently
n
Always
This student is motivated to complete tasks given: This student follows instruction:
n
Never
n
Rarely
n
Sometimes
n
Frequently
n
Always
n
Never
n
Rarely
n
Sometimes
n
Frequently
n
Always
This student shows level of creativity: Has this student ever been sent to the principal’s or vice principal’s office for
n
Never
n
Rarely
n
Sometimes
n
Frequently
n
Always behavior-related issues?
n
Yes
n
No
What other information about this student should the Excursions in Learning Program consider?
REQUIRED
Signature of Teacher/Counselor Completing Form Date
January 2020/PR
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Student Recommendation Excursions in Learning

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Completed 25 July 2020

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