STUDENT REFERENCE ONLINE FORM

Student Reference Online Form
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. You may also fill this out online at: https://weimaracademy.org/student-reference-form/. You may email, fax or mail it back.

Weimar Academy, PO Box 486, Weimar, CA 95736; Fax 530-422-7910; [email protected]

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.

SOCIABILITY

Secure, Outgoing, Friendly *

Shy, Introverted, Unsocial

SPIRITUALITY

Strong, Stable, Growing *

Immature, Shaking, Stagnating

JUDGMENT

Sound, careful, Teachable *

Rash, Impulsive, Headstrong

SERVICE ATTITUDE

compassionate, Unselfish *

Indifferent, Self-centered

INDUSTRIOUSNESS

Diligent, Thorough *

Lazy, Incomplete, Needs supervision

CHOICE OF FRIENDS

High standards, Careful *

No standards, Careless

HEALTHY LIFESTYLE

Healthful, Conscientious *

Uninformed, careless, Seems sickly

INFLUENCE ON OTHERS

Good, Helpful, OK *

Passive detrimental

TRUSTWORTHINESS

Conscientious, Dependable *

Needs guidance, Irresponsible

INTELLECT

Vigorous, creative, Learning *

can’t make ends meet, high risk

FINANCES

Account current, Will be paid *

Slow, Unmotivated, self-satisfied

EMOTIONAL STABILITY

Solid, Positive, Secure *

Dependent, Weak, Troubled

ATTITUDE TO AUTHORITY

Teachable, Obedient *

Rebellious, Querulous, Resentful

Considering the applicant for acceptance as a student at Weimar Academy: *