Teacher Recommendation Form
Work Based Learning programs are an extension of school-based curriculum into the workplace. The student listed below has applied to participate in Work Based Learning. Please assist us by completing this form and returning it to the WBL Instructor as quickly as possible. Thank you.

Student’s Name:	School:   	

Please check in the appropriate column the factors for which you have adequate information for appraisal.

GOOD	
FAIR	
POOR	
1.	Ability to follow instructions				
2.	Social skills (gets along well/respect for others)				
3.	Demonstrates dependability				
4.	Self-motivated				
5.	Demonstrates responsibility (directs energies toward tasks				
6.	Demonstrates enthusiasm in performing assigned tasks				
7.	Strives for excellence				
8.	Punctual				
9.	Mentally alert (organization skills/problem-solving skills)				
10.	Demonstrates proper etiquette and manners				
11.	Personal appearance/grooming				
12.	Demonstrates integrity/honesty				
13.	Demonstrates optimism and self-respect				
14.	Capacity to try new ideas and increase knowledge				
15.	Attitude toward constructive criticism				
16.	Ability to adapt to change				
17.	Cooperates with others				
18.	Communication skills				
19.	Demonstrates attention to detail				
20.	Ability to set realistic goals				

Do you recommend this applicant for the Work Based Learning program?		□ Yes	□ No Signature	Date