Teacher Recommendation Form Name of teacher completing the form * First Name Last Name School Name * Students Name * How long have you known this child? * Grade Level Entering in the Fall * Transitional Kindergarten (TK) Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Other Areas of Strength (check all that apply) * Basic Reading Skills Reading Comprehension Listening Comprehension Math Calculation Math Problem Solving Organization Expressive Language Writing Skills Peer Relationships Behavior/Attitude Reading Fluency Following Multi-step Directions Classroom Behavior (check all that apply) * Needs support following standard classroom routines Observable self-advocacy (asks for help, etc) Difficulty following directions Disrupts other student's working Responds positively to feedback Becomes upset when given a correction or reminder Needs to be redirected often (more than 3 times per lesson) Has difficulty working independently Interpersonal Behavior and Activity Level (check all that apply) * Lots of energy (fidgets, squirms, out of seat) Appropriate eye contact Appropriate level of activitywBehavior is distracting to others In control of behavior Minimal or no eye contact Daydreamer/lost in thought Temper tantrum/breakdown Distracted by classroom Motivation, Effort and Work Habits (check all that apply) * Remains on task Appears engaged in classroom activities Initiates tasks independently Materials appear organized Dependent on teacher support Dependent on peer support Gives up easily Becomes frustrated quickly Participattes in class/asks questions Affect/Mood (Check gernal daily demeanor) * Happy Angry Depressed/Sad Anxious Easily Upset For TK and Kindergarten Only: Child is able to use the bathroom independently Yes No Additional Information Classroom Relationship with Teacher * Cooperative with teachers Seeks adult attention (+/-) Disrespectful of Teachers Requires Teacher support for majority of tasks Withdrawn/Unresponsive to teacher Classroom Relationship with Peers (check all that apply) * Participates positively in group work or play Onlooker/observer in group work or play Interactions are appropriate Exhibits distracting behaviors with peers Is well-liked by peers Thank you for taking the time to complete the student recommendation form. Please add observations or important information you would like to share about this student: * Thank you!
