PASIG CATHOLIC COLLEGE

GRADE SCHOOL DEPARTMENT

ADVISER/GUIDANCE COUNSELOR`S RECOMMENDATION FORM

Name of Pupil:
LAST FIRST MIDDLE NAME

Name of School: Grade Level:

To the Adviser/Guidance Counselor: Your son/daughter is an applicant to the Grade School

Department of Pasig Catholic College. The Committee on Admission would appreciate your
opinions below. Please make your judgment carefully and fill out the form completely as it will
surely be used in the evaluation of the student. After accomplishing this form, please place it in an
envelope, seal and sign across the flip and submit to the Guidance Center. Unsealed and
unsigned recommendations will not be accepted. Thank you for your cooperation.

Please check appropriate boxes: 5 = Area of Strength 4 = Age Appropriate 3= Working Towards
2 = Area of Concern 1 = Not Applicable

5 4 3 2 1
1. Separates from parent
2. Well liked by peers
3. Becomes engaged with
a. peers
b. adults/staffs
4. Accepts limits/boundaries
5. Tolerates frustration with:
a. assigned tasks
b. chosen task
6. Cooperates
7. Show respect for properties
8. Shows confidence
9. Accepts guidance
10. Displays good manners
11. Is aware of other`s feelings
12. Shows initiative
13. Can be friend
14. Seek help when needed
15. Is comfortable with:
a. peers
b. adults/staffs
16. Shows/demonstrates good impulse control at:
a. class
b. playground
17. Attention span: can concentrate for a long period of time
18. Study habits
19. Easy to manage and control
20. Clear speech, easy to understand
21. Rarely demands a great deal of attention
22. Doesn`t have temper tantrums
23. Sociable
24. Rarely bites, kicks, hits or fights with other children
25. Hardly ever interferes
26. Is mature for age/grade
Does student have any outstanding abilities or deficiences not covered by the above categories?

Yes No

Have you observed any signs of learning disablities, ADHD/ADD, or any noticeable behaviors that
may need special attention?

Yes No

*If yes, please explain (continue on a separate sheet if needed):

Has strongly do you recommend this student?

Yes No

*If yes, why?

How strongly do you recommend this student?

Ethusiastically Strongly Fairly Strongly

w/o Ethusiastically Not Recommended

Complete name of person completing this form Signature

Relation to the student/applicant Date Accomplished