Reference for Potential Student

Sampson Early College High School

 

Name of Applicant _____________________________________

 

Length of time& relationship to applicant __________________________________

 

Please check the appropriate response based on your personal knowledge of the applicant.

Quality

Unable to Judge

Below

Average

Average

Top 50%

Very Good

Top 10%

Outstanding

Top 1 %

Academic Integrity

 

 

 

 

 

 

Personal Integrity

 

 

 

 

 

 

Motivation, Initiative

 

 

 

 

 

 

Oral Communication

 

 

 

 

 

 

Written Communication

 

 

 

 

 

 

Creativity

 

 

 

 

 

 

Self-confidence

 

 

 

 

 

 

Leadership

 

 

 

 

 

 

Responsibility

 

 

 

 

 

 

Respect for others

 

 

 

 

 

 

Concern for others

 

 

 

 

 

 

Sense of humor

 

 

 

 

 

 

Emotional maturity

 

 

 

 

 

 

Academic potential

 

 

 

 

 

 

Attitude

 

 

 

 

 

 

Trustworthy, Reliable

 

 

 

 

 

 

Helpful to others

 

 

 

 

 

 

Enthusiasm

 

 

 

 

 

 

 

Optional Comments (Please take time to say something about the candidate in your own words – the admission committee reads all comments)

 

 

 

 

 

 

Signature ________________________________________ Title ___________________

 

Address ________________________________________________________________

 

City ________________________  State _________________  Zip ________________

 

Day Phone ____________________  Evening Phone ___________________________

 

Date _________________________