Character Reference Form

Corozal ITVET
TO BE FILLED OUT BY THE APPLICANT

This form should be filled by a teacher. The teacher is asked to fill this form and seal the filled form in an
envelope. All information in this form will be held in the strictest confidence and will not be shared with
students, parents or guardians.

Applicant’s Name
Surname First Name Middle Initials

Program Applying for Age Gender: M / F

Applicant’s Current/Previous School

Address of Current/Previous School

Telephone #

Applicant Signature Date

TO BE FILLED OUT BY THE RECOMMENDER

The information will be kept confidential. Please be as thorough as possible.

Name

Post School

Email Phone #

What is the greatest strength of this student?

What is this student’s greatest weakness?

What factors in the applicant’s home life would help or hinder his/her educational success?

Corozal ITVET Character Reference Form

Character Reference Form
Corozal ITVET
What is this student’s attitude towards authority and rules?

Do you have any concerns in particular about this child? Yes / No

If yes, please explain.

Below, please evaluate the applicant in the following categories.

Poor Average Excellent

Academic achievement
Academic potential
Creativity
Leadership ability
Personal integrity
Study habit
Initiative
Intellectual curiosity
Writing ability
Oral expression
Sense of humor
Emotional maturity
Conduct
Concern for others
Relationship with peers
Relationship with adults

__________________________________ ________________________
Recommender’s Signature Date

Corozal ITVET Character Reference Form