BCA Administrator/Teacher Reference Form

Please complete the following information for the student applying for enrollment at Belvoir Christian Academy.

Student Applicant Namerequired

First Name

Last Name

Seeking admission to grade:required

Individual completing this formrequired

First Name

Last Name

Phonerequired

Email required

Your title/relationship to student required

School where you taught studentrequired

How long have you known the applicant? required

Are you aware of any mental, physical, emotional or social issues that would hinder this applicant from being successful in a typical educational setting? (If yes, explain below.)required

To your knowledge, does the applicant come from a Christian home, a well-disciplined home, and/or receive encouragement at home?required

Has this student ever been suspended (in-school or out-of-school) or been asked to withdraw from school? If yes, explain: required

Does this student have any personal habits/attitudes that you feel are inconsistent with attendance at a Christian school? If yes, explain:

Describe the student's strengths and weaknesses:required

Recommendation of this applicant could best be described as a candidate for admission:required

With confidence

With reservation

Not recommended

APPLICANT'S CHARACTERISTICS

Please choose appropriate recommendation for the following areas.

Please add comments or concerns: