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Academic Reference Form (2021-2022)
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* Indicates required question
Email
*
Your email
Student's Name
Your answer
Student's Date of Birth
MM
/
DD
/
YYYY
Reference's Name
Your answer
Reference's Phone Number
Your answer
Reference's Email
Your answer
Please list any grades/classes you taught this student
Your answer
Please list any extracurricular activities you mentored or taught this student.
Your answer
Do you know this student personally or from a family acquaintance? If yes, please explain
Your answer
How long have you known the applicant?
Your answer
How well do you know the applicant?
Not Well
Somewhat Well
Fairly Well
Well
Clear selection
What gifts or attributes has the student demonstrated that you believe will be assets to Resurrection Lutheran School?
Your answer
What types of teaching, support, or experiences do you hope the student will receive should he/she be accepted to RLS?
Your answer
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