Are you currently taking any medication? If so, please list.
Are you allergic to any medication? If so, please list.
Name of personal physician and physician’s phone number:
MARENGO COMMUNITY HIGH SCHOOL
The parent and/or student has requested that the teacher fill in this report in class today and return to the student by the end of the period.
DATE:___________________ STUDENT:______________________________________
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MISSING ASSIGNMENTS/COMMENTS
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3
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4
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5
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TEACHER EVALUATION FOR DANCE TRYOUTS
Please complete the following form and return it in a sealed envelope no later than noon on Thursday, May 9th. Evaluations can be returned to the office at your respective school, and will be picked up by the coach, or other representative, Thursday afternoon.
Teacher evaluations will be added in with the other evaluation forms used during tryouts and will make a difference in total points. It is important that you rate the student according to how YOU feel the student does in your class(es). Please be realistic as well as fair. These evaluations will not be shared with the student. They will be confidential and tallied by the coaches.
Thank you for your time and cooperation. If you have any questions, please feel free to contact us.
Name of Candidate:__________________________________________________________________________________
Class(es) Taught:____________________________________________________________________________________
Approx. GPA:_______________________________________
Has this student ever needed to be disciplined by you, and if so, what was the offense?___________________________
On a scale of 1 to 5, please rate the candidate in each of these areas: 1 = low 5 = high
_____ Ability to get along with others
_____ Attitude
_____ Cooperation
_____ Attendance and punctuality
_____ Dependability
_____ Demonstrates leadership qualities
(Optional) Comments:____________________________________________________________________________
Signature of Teacher:_________________________________________________ Date:_____________________
Name of School:_________________________________________________________________________________
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