2026 RGVSSI Teacher Reference Form

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Questions marked with a * are required

Student Name:

School:

School District:

School Address (Street, City, State, Zip Code)

Your Name:

Title (teacher, counselor, etc.):

Email Address:
Please submit an institutional email address and not a personal email address.

Phone Number:

Ext.

Rate the student in all categories with which you feel qualified to assess characteristics for relative to other students in the same academic classification (i.e., sophomore, junior) and with whom you have had contact.

	Below Average	Average	Good	Excellent	Outstanding
Desire to learn	Below Average	Average	Good	Excellent	Outstanding

Curiosity	Below Average	Average	Good	Excellent	Outstanding

Creativity	Below Average	Average	Good	Excellent	Outstanding

Hard working	Below Average	Average	Good	Excellent	Outstanding

Perseverance	Below Average	Average	Good	Excellent	Outstanding

Ability to adapt to new situations	Below Average	Average	Good	Excellent	Outstanding

Interpersonal skills	Below Average	Average	Good	Excellent	Outstanding

Analytic problem solving	Below Average	Average	Good	Excellent	Outstanding

Scientific knowledge	Below Average	Average	Good	Excellent	Outstanding

Technical expertise	Below Average	Average	Good	Excellent	Outstanding

Please include comments that provide any information you feel would be helpful in assessing the student's qualifications:

Please note that we will be sending you a confirmation email to ensure the form was completed by a teacher/counselor.

In order to submit the form, click the "Done" button!

Thank you for your time and for supporting your student's success!

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