What is your relationship to the student? (NOTE: Parents/Guardians and family members are not allowed to do a recommendation. *
Student's LAST Name? *
Your answer
Student's FIRST Name? *
Your answer
Student's Grade? *
Which DCIS School? *
Compared to other students/young people of this age, how would you rate their level of responsibility? *
extremely irresponsible
extremely responsible
Why did you answer in this way? Be specific and succinct. *
Your answer
Compared to other students/young people of this age, how would you rate their leadership? *
not much of a leader
extremely effective leader
Why did you answer in this way? Be specific and succinct. *
Your answer
Compared to other students/young people of this age, how would you rate their maturity? *
very immature
very mature
Why did you answer in this way? Be specific and succinct. *
Your answer
Finally, take your experience and characteristics like responsibility, leadership, and maturity into consideration - what is your OVERALL rating for this student? *
low
high
Is there anything else you would like the DCIS Foundation to know about this student?
Your answer
Thank you for your time. Date application is final and submitted. *
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A copy of your responses will be emailed to the address you provided.