Rio Norte Jr. High School Student Leader Reference Form
Directions:  Please score the student leadership candidate on the following criteria.  He/she is being considered for a position of great responsibility and leadership in ASB (student council)  Your HONEST ASSESSMENT of this student is taken very seriously.  While comments are not required, they can prove enormously helpful in a very competitive process such as this.  Your individual scores and comments are NEVER shown to the students or parents, to maintain confidentiality.  This assessment should be submitted by Sunday, April 9th, 2017.  Thank you so much for your time.
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Student's Last Name *
Student's First Name *
Name of Reference *
Your name
Relationship of reference to student *
Ex. 6th grade Teacher, coach, scout leader, pastor, etc.
Reference E-mail *
If a teacher, please include your work e-mail
Guide for Scoring Candidates
1 means - the student never or hardly ever displays the characteristic at all

2 means - the student displays the characteristic less than what is expected of a student leader

3 means - the student displays the characteristic as expected of a student leader

4 means - the student displays the characteristic MORE often than expected of a student leader

5 means - the student displays the characteristic at the very highest level; this student serves as a clear example to others in this particular area, and FEW OTHERS IN YOUR CAREER match this student's excellence in the area.

"N/A" means - the student may or may not display the characteristic, but you have not had a chance to observe it in your particular setting.  Please skip the question if it does not apply.  A score of "n/a" will NOT factor into student's final score index
Student takes initiative and shows self-motivation
Clear selection
Student shows respect for both adults and peers
Clear selection
Student demonstrates emotional maturity
Clear selection
Student is on time to class and turns assignments in on time
Clear selection
Student is trustworthy and honest
Clear selection
Student is kind and caring to others in both words and actions
Clear selection
Student works well as a member of a team
Clear selection
Student enthusiastically participates in class activities and discussions
Clear selection
"Gut feeling" - on a scale of 1-5, what is this student's leadership potential? *
5 Being best
Comments
Any information you can add will be very helpful in this competitive process
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