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ETIP Institute for Black History & Leadership Teacher Behavioral & Character Recommendation Form

"*" indicates required fields

Student's Full Name*

First Last

RECOMMENDER: If you choose to submit a letter of recommendation in addition to this form, it must be printed on official institution letterhead and uploaded to this form.

Reference Provided By:

Recommender’s Name*

First Last

School Name*

Email Address*

Phone*

Please rate the applicant on the attributes and skills below:

Academic Excellence*

Outstanding

Good

Fair

Poor

Unable to Judge

Innovation*

Outstanding

Good

Fair

Poor

Unable to Judge

Tenacity*

Outstanding

Good

Fair

Poor

Unable to Judge

Peer Collaboration*

Outstanding

Good

Fair

Poor

Unable to Judge

Integrity*

Outstanding

Good

Fair

Poor

Unable to Judge

Respect for Authority*

Outstanding

Good

Fair

Poor

Unable to Judge

Classroom Leadership*

Outstanding

Good

Fair

Poor

Unable to Judge

Maturity*

Outstanding

Good

Fair

Poor

Unable to Judge

Initiative*

Outstanding

Good

Fair

Poor

Unable to Judge

Mathematics Skills*

Outstanding

Good

Fair

Poor

Unable to Judge

Writing Skills*

Outstanding

Good

Fair

Poor

Unable to Judge

Ability to Work with Others*

Outstanding

Good

Fair

Poor

Unable to Judge

Ability to Work Alone*

Outstanding

Good

Fair

Poor

Unable to Judge

Self Management*

Outstanding

Good

Fair

Poor

Unable to Judge

How long have you known the applicant?*

In what capacity have you known the applicant?*

The ETIP INSTITUTE FOR BLACK HISTORY & LEADERSHIP 2023 provides rigorous, project-based learning for ambitious 4th through 8th grade scholars. Concepts of leadership, advocacy for community engagement, and principles of emotional intelligence are incorporated as well. The Institute is not designed to “catch students up” to appropriate leveled academic coursework but rather to prepare them for above-level academic experiences. Do you have any concerns about this student’s ability to participate and perform successfully in the ETIP INSTITUTE FOR BLACK HISTORY & LEADERSHIP 2023?

No, I do not have any concerns.

Yes, I do have some concerns.

Please explain

Please describe the energy this student brings to your class:*

Is there anything else you wish to share (optional)?*

Letter of Recommendation (Optional)

Max. file size: 50 MB.

Recommender Signature

Date*

MM slash DD slash YYYY

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Summer Experience
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