CONFIDENTIAL STUDENT RECOMMENDATION FORM

GUIDANCE AND ADMISSIONS OFFICE CONFIDENTIAL STUDENT RECOMMENDATION FORM (To be accomplished by two (2) of the following: Dean, Principal, Class Advise...

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City of San Fernando, Pampanga

GUIDANCE AND ADMISSIONS OFFICE CONFIDENTIAL STUDENT RECOMMENDATION FORM

(To be accomplished by two (2) of the following: Dean, Principal, Class Adviser or Counselor) The Committee on Admissions requests your kind cooperation in providing an honest and specific evaluation of the applicant whose name appears below. The applicant’s admission will be based on this recommendation together with the results of the test of the University of the Assumption. This form should be placed inside a sealed envelope, countersigned across the flap by the evaluator and be hand carried by the applicant. The applicant will not be admitted for testing until we have received this form. Prompt transmission of this rating form will be deeply appreciated. INFORMATION WILL BE HELD IN STRICT CONFIDENTIALITY.

Name of Applicant: _____________________________________________________________________________________________________________________________ Last Name

First Name

Middle Name

Strand Applied for: ___________________________________________________________________________________________________________________________ 1. How long and in what capacity have you known the applicant? _________________________________________________________________________ 2. What is the grade point average (GPA) of the applicant based on his/her previous academic performance? (Please check below) 90% & above

85-89%

80-84%

below 80%

3. Please rate the applicant in terms of the main factors contributing to the respect accorded him/her. (Please check) Excellent

Very Good

Good

Poor

Not Observed

1. Academic Performance 2. Communication Skills 3. Emotional Maturity 4. Leadership Skills 5. Study Habits 6. Relationship with Others 4. Check any of the following, which you feel describes the applicant’s general personality make-up. Sociable

Responsible

Obedient

Talented

Assertive

Honest

5. Has the applicant been subjected to any disciplinary action? (Please check) YES

NO

If yes, please explain______________________________________________________

6. For guidance and counseling purposes, please check if the applicant has been involved in the following cases: Excessive Absences

Fraternities/ Sororities

Use of prohibited drugs/ alcohol

Excessive on-line game use

Acts of Dishonesty

Teenage Pregnancy

Suicidal Acts/Tendencies

Violence

Disrespect

Others: (pls. specify) _________________________________________________________________________ REMARKS/ RECOMMENDATION: ____________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________

Signature: ______________________________________________ Name: ______________________________________________ Position: ______________________________________________ School: ______________________________________________ Address: ______________________________________________ Date: ______________________________________________ Tel.Nos: ______________________________________________

Please return this form to: SENIOR HIGH SCHOOL GUIDANCE & ADMISSIONS OFFICE University of the Assumption City of San Fernando 2000 (P) Tel.No. 045.961.1482 local 144

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------GUIDANCE & ADMISSIONS OFFICE Benedictine Building Tel.No. (045) 961-1482 Local 144 www.ua.edu.ph