Fillable Printable Student Evaluation Form - Washington

Student Evaluation Form - Washington

GonzaGa PreParatory School

Student evaluation Form

For IncomInG 9

Grade StudentS

note to Student and Parent: this survey form is to be delivered to the appropriate school ofﬁcial (teacher, counselor

or principal) and returned to Gonzaga Preparatory School, 1224 e. euclid Spokane, Wa 99207.

SectIon I - to Be comPleted By Parent or GuardIan

Please Print or type

Student’s name____________________________________________date of Birth ____________________

Last First Middle

Parent/Guardian __________________________________________________________________________

Last First Middle

Parent contact email ______________________Parent contact Phone number ______________________

Present School ____________________________________________number of years attended _________

I authorize ___________________________________ School to release all educational, disciplinary, and

counseling records and information pertaining to my student to Gonzaga Preparatory School.

Parent or Guardian Signature_______________________________________ date signed ____________

note: This authorization must be signed and dated in order for the student to be considered for admission.

ParentS: the Federal educational rights and Privacy act (FerPa) or other laws or school policies may guarantee you rights to

view your child’s education records or to access the information within them. Gonzaga Prep is suggesting you waive any such

rights with regard to this Student Survey Form after it is completed, so that the school ofﬁcial(s) completing it may feel free to

give a candid appraisal of your student’s abilities and the suitability of Gonzaga Prep’s program for him/her. you are not obliged

to sign the following waiver as a condition of your son/daughter being considered for admission to Gonzaga Prep.

WaIVer

I hereby request and direct an ofﬁcial(s) of the above-named school to complete this Student Survey Form; in so doing, I waive

any rights I or my spouse or student might otherwise have had under FerPa or other law or school policies, as to Gonzaga

Preparatory School or the school above-named, to view this Form after completion or to access any of the information conveyed

by the completed Form:

Parent or Guardian Signature_______________________________________ date signed ______________

SectIon II - to the teacher, counSelor or PrIncIPal

this student is applying for admission to Gonzaga Prep for the coming school year. PleaSe comPlete thIS Form aS

comPletely and accurately aS PoSSIBle so that a fair evaluation of the student may be made. candid answers are

appreciated. this information is used for admissions and to help assist with proper placement in courses. this information will

remain conﬁdential if the waiver in Section I has been signed by a parent or guardian.

• Please submit a copy of the student’s nal 7th grade report card, and his/her grade reports for the rst

grading period of the 8th grade year.

• Please indicate this student’s current grade point average:

4.00 - 3.50 3.49 - 3.00 2.99 - 2.50 2.49 - 2.0 below 2.00

• Does this GPA reect accommodations? Yes No

If yes, please explain _______________________________________________________________________

• Does this GPA reect modied course of studies? Yes No

If yes, please explain _______________________________________________________________________

• Please submit the student’s most recent standardized test scores.

• Do you think the test scores reect actual achievement? Yes No

GONZAGA

REPARATORY

SCHOOL

What will be the last level of Math completed at the end of the student’s 8th grade year? _______________________

Scholastic ability and Promise Superior above average average Below average lacking

reading ability & comprehension

master of english Fundamentals

arithmetic: computation

concepts

Problem Solving

If any ratings were Below Average or Lacking, please explain:

character and Personality rating Superior above average average Below average lacking

application to Studies

cooperation in School

relationship with Peers

Participation in activities

attendance

If any ratings were Below Average or Lacking, please explain:

Please mark any of the following that apply: Signicant health or physical disabilities?

Home conditions likely to affect school performance?

Signicant behavior or personality problems?

explain if any of the above items were marked: _________________________________________________

________________________________________________________________________________________

In what school activities has the student been involved in the last two years (e.g. sports, ne arts, clubs)?

________________________________________________________________________________________

Please elaborate on any leadership abilities and/or outstanding talents.

________________________________________________________________________________________

Do you feel this student can handle a college preparatory program? Yes No If no, please explain:

________________________________________________________________________________________

Please add any additional comments on this student (e.g., how would you compare this student to others

in his/her class?). __________________________________________________________________________

________________________________________________________________________________________

Would you like a telephone conference? Yes No

If substantial changes in academics or behavior occur, please contact the

Admission Director at Gonzaga Prep.

________________________________________________________________________________________

School Ofﬁcial’s Name School Ofﬁcial’s Position Date

________________________________________________________________________________________

Contact Number Best Time To Call