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Teacher Evaluation Form

The teachers can grade a teacher based on their performance over a given semester using the Teacher Evaluation Form.

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©2012 The Common Application, Inc.	AP-6	/2012-13	
TO THE APPLICANT	
After completing all the relevant questions below, give this form to a teacher who has taught you an academic subject (for example, English, foreign language, math, 
science, or social studies). If applying via mail, please also give that teacher stamped envelopes addressed to each institution that requires a Teacher Evaluation.
Legal Name ___________________________________________________________________________________________________________________	
Last/Family/Sur   (Enter name exactly as it appears on official documents.) First/Given    Middle (complete) Jr., etc.	
Birth Date ___________________________________________________  CAID (Common App ID) _______________________________________________	mm/dd/yyyy	
Address ________________________________________________________________________________________________________________________                      Number & Street                  Apartment # City/Town State/Province Country ZIP/Postal Code
School you now attend ________________________________________________________ CEEB/ACT  Code  _____________________________________	
TEACHER EVALUATION 1	
TO THE TEACHER	
The Common Application membership finds candid evaluations helpful in choosing from among highly qualified candidates. You are encouraged to keep this form 
in your private files for use should the student need additional recommendations. Please submit your references promptly, and remember to sign below before 
mailing directly to the college/university admission office. Do not mail this form to The Common Application offices.
Teacher’s Name (Mr./Mrs./Ms./Dr.) _______________________________________________ Subject Taught _______________________________________	
Please print or type	
Signature _________________________________________________________________________________________________  Date _____________________	mm/dd/yyyy	
Secondary School _______________________________________________________________________________________________________________
School Address  ________________________________________________________________________________________________________________	
Number & Street City/Town State/Province Country ZIP/Postal Code	
Teacher’s Telephone (_______) __________________________________________________ Teacher’s E-mail _____________________________________	Area/Country/City Code Number Ext.	
Background Information
How long have you known this student and in what context? _______________________________________________________________________________
What are the first words that come to your mind to describe this student? _____________________________________________________________________
In which grade level(s) was the student enrolled when you taught him/her?	
 9	 10	 11	 12	 Other_____________________________________
List the courses in which you have taught this student, including the level of course difficulty (AP, IB, accelerated, honors, elective; 100-level, 200-level; etc.).
_______________________________________________________________________________________________________________________________	
2012-13 Teacher Evaluation	
For Spring 2013 or Fall 2013 Enrollment	
 Female
 Male
TE	
IMPORTANT PRIVACY NOTICE: Under the terms of the Family Educational Rights and Privacy Act (FERPA), after you matriculate you will  have access to this form 
and all other recommendations and supporting documents submitted by you and on your behalf, unless at least one of the following is true:
1. The institution does not save recommendations post-matriculation (see list at www.commonapp.org/FERPA).
2. You waive your right to access below, regardless of the institution to which it is sent:
Yes, I do waive my right to access, and I understand I will never see this form or any other recommendations submitted by me or on my behalf.No, I do not waive my right to access, and I may someday choose to see this form or any other recommendations or supporting documents submitted by me 
or on my behalf to the institution at which I'm enrolling, if that institution saves them after I matriculate.
Required Signature _______________________________________________________________________________________  Date _________________

©2012 The Common Application, Inc.	TE-2	/2012-13	
Ratings	Compared to other students in his or her class year, how do you rate this student in terms of:	
No basisBelow 
average AverageGood (above 
average)Very good 
(well above 
average)Excellent 
(top 10%)Outstanding
(top 5%)One of the top 
few I’ve encoun-
tered
(top 1%)	
Academic achievement
Intellectual promise
Quality of writing
Creative, original thought
Productive class discussion
Respect accorded by faculty
Disciplined work habits
Maturity
Motivation
Leadership
Integrity
Reaction to setbacks
Concern for others
Self-confidence
Initiative, independence
OVERALL	
Evaluation  	Please write whatever you think is important about this student, including a description of academic and personal characteristics, as demonstrated in 
your classroom. We welcome information that will help us to differentiate this student from others. (Feel free to attach an additional sheet or another reference you may 
have prepared on behalf of this student.)	
TEACHER EVALUATION 1
Next: Temporary Hardship Forbearance Form Previous: Training Evaluation Form
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