Recommendation Form

GDC-FRM-004(001)
rev.08 24.18
St. Paul University Quezon City

St. Paul University System
No. 16 Gilmore Avenue, cor. Aurora Blvd., Quezon City
Guidance and Counseling Services

Tel. No. 726-7986 to 88 loc. 148 FAX No. 723-055 E-mail Add.: [email protected]
Recommendation Form
To the Applicant: Please fill up the items in this section. Type or print your answers.
Name:
_____________________________________________________________________________________________________________________
LAST FIRST MIDDLE
Complete Personal Address:

__________________________________________________________________________________________________
College Program Applied for: 1st ____________________ 2nd ____________________ Grade/ Year Level Applied for: ____________
Complete Name of Current/Last School:

_____________________________________________________________________________________________________________________
Complete School Address:

_____________________________________________________________________________________________________________________
_____________________________________ ______________________________
Applicant’s Signature Date
To be Completed by the Recommender: (Recommendation should come from any of the following:
School Principal/ Guidance Counselor/ Class Adviser) The student whose name appears above is studying or has
studied in your school and is applying for admission in St. Paul University Quezon City. Your help in providing us with
specific information about his/her accomplishments and qualification is most welcomed.
Please tick off the box that corresponds to your responses. Countersign all erasures and corrections made. Please
provide additional comments not covered by the items given below. Please feel free to attach additional sheets for
information that could help us in our evaluation.
A. THE RECOMMENDER’S ASSESSMENT

Below Average Above No Basis
Average Average
_______________________________________________________________________________________________________________________
1. Intellectual Capacity
2. Academic Motivation
3. Oral Communication Skills
4. Written Communication Skills
5. Self-Confidence
6. Emotional Stability/ Maturity
7. Interpersonal Skills
8. Self-Discipline
9. Leadership Potential
10. Integrity
Additional Comments:_____________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
_________________________________________________________________________________________________
1. Has the applicant been subjected to any disciplinary action? Yes No Major Offense Minor Offense
Any form of Cheating Habitual Tardiness Bullying Gambling
Disrespect to Authority Habitual Absenteeism Smoking Brawling
Use of Profane Language Use or Abuse of Prohibited Drugs Others: Please Specify____________________
If he/ she is subjected to any offense given above, please state the following:
Penalty/ Sanction Given Period Covered
__________________________________________________________________ ______________
__________________________________________________________________ ______________
__________________________________________________________________ ______________
2. Does the applicant have any of the following?
Learning Difficulty Behavioral Concern/s Emotional Concern/s
Physical Disability Psychological Concern/s None
Please specify the nature of concern:______________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
B. RECOMMENDATION
Please tick the single appropriate box:
This student is RECOMMENDED
This student is RECOMMENDED WITH RESERVATION due to ________________________
This student is NOT RECOMMENDED
This report is based on ( tick the appropriate box/es):
personal observation teacher’s comments
school records other records

please specify __________________________
**Please seal this form in an envelope and sign on the flap. Return to the student for submission to our
office. An unsealed and unsigned recommendation is not valid and will not be accepted.**
Name: __________________________________________________________________ Signature: _________________________
Designation: ___________________________ Office Address: _____________________________________________________
Contact No.: _______________________ E-mail Add. : _______________________ Date: ______________________________
Thank you for completing this student’s recommendation form.
Affix
Dry Seal
All ratings, responses and recommendations in this form and attachments are regarded as confidential.
Caritas Christi Urget Nos!

A Paulinian is a Christ-centered person who is simple, warm and active with passion for service

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GDC-FRM-004(001)

St. Paul University Quezon City

Guidance and Counseling Services

Complete Personal Address:

Complete Name of Current/Last School:

Complete School Address:

A. THE RECOMMENDER’S ASSESSMENT

3. Oral Communication Skills

4. Written Communication Skills

6. Emotional Stability/ Maturity

Any form of Cheating Habitual Tardiness Bullying Gambling

Disrespect to Authority Habitual Absenteeism Smoking Brawling

Penalty/ Sanction Given Period Covered

2. Does the applicant have any of the following?

Learning Difficulty Behavioral Concern/s Emotional Concern/s

Physical Disability Psychological Concern/s None

Please specify the nature of concern:______________________________________________________________________________

This student is RECOMMENDED

This student is RECOMMENDED WITH RESERVATION due to ________________________

This student is NOT RECOMMENDED

This report is based on ( tick the appropriate box/es):

personal observation teacher’s comments

school records other records

Name: __________________________________________________________________ Signature: _________________________

Designation: ___________________________ Office Address: _____________________________________________________

Contact No.: _______________________ E-mail Add. : _______________________ Date: ______________________________

Thank you for completing this student’s recommendation form.

Caritas Christi Urget Nos!

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Name: __________________________________________ Signature: _

Designation: _ Office Address: ___________________________

Contact No.: ___________ E-mail Add. : _ Date: ____________________