The above named person has applied for admission to Weimar Academy and has given your name as a reference. Please be honest and candid in your evaluation. This referral will be kept strictly confidential. Since this form must be on file before his/her admission can be considered, please return it promptly.
Weimar Academy, PO Box 486, Weimar, CA 95736; Fax 530-422-7910; email@example.com
Please select the number which best describes the applicant in each of the areas of growth listed below.
Note: 5 indicates the applicant is most like the characteristics on the left side, and 1 the characters on the right side. If you feel you cannot honestly evaluate a certain characteristic, please select the N/A.
Secure, Outgoing, Friendly
Shy, Introverted, Unsocial
Strong, Stable, Growing
Immature, Shaking, Stagnating
Sound, careful, Teachable
Rash, Impulsive, Headstrong
Lazy, Incomplete, Needs supervision
CHOICE OF FRIENDS
High standards, Careful
Uninformed, careless, Seems sickly
Needs guidance, Irresponsible
Vigorous, creative, Learning
can’t make ends meet, high risk
Account current, Will be paid
Slow, Unmotivated, self-satisfied
Solid, Positive, Secure
Dependent, Weak, Troubled
ATTITUDE TO AUTHORITY
Rebellious, Querulous, Resentful
Considering the applicant for acceptance as a student at Weimar Academy: