Heritage Academy Christian School

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Heritage Academy                                                                                                    Counselor or Administrator Evaluation
Applicant’s Name _________________________________Applying for Grade________

Counselor or Administrator Evaluation
Name of person completing this report: _______________________________________________________________
Name of school: _________________________________________________________________________________
1. I have known the above applicant for __________________ as his/her __________________________________
2. This report is based on: _____ Personal observation and contact with student _____ Teacher Comments ________
Other counselor’s observations _____ Records ____ Other (explain) _______________________________
3. The student has been sent to the office for disciplinary reasons: ____ Often ____ Seldom ____ Never
Please describe problem(s) ________________________________________________________________________
_______________________________________________________________________________________________
______________________________________________________________________________________________
4.This student has been suspended _____ times. Reason(s) _____________________________________________
5. Has the applicant been expelled or dismissed from school for academic or disciplinary reasons and therefore not
eligible to return? ____ Yes ____ No Explain: __________________________________________________
6. Do you have any reason to doubt this student’s academic integrity? ________ Yes _______ No
7. The applicant’s attendance has been: ______ Excellent _____ Good _____ Poor
8. The applicant’s parents can best be described as: (Circle as many as apply)
Involved Cooperative Difficult Uninvolved
Tends to blame school for student’s problems
9. Does the applicant have any significant limitations (physical, social/emotional, academic/learning disabilities)
Please describe: __________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

Contact Heritage Academy Christian School

7216 U.S. Highway 42
Florence Kentucky 41042
(859)525-0213
info@haeagles.org

  • About Us
    • Mission Statement
    • Statement of Faith
    • Philosophy of Education
  • Admissions
    • Application Process
    • Tuition Schedule
    • Student Handbook
  • Academics
  • Athletics
  • Arts
  • Support
  • MySchoolWorx
  • Facebook News
  • FAQ
  • Contact Us
    • Employment Opportunities
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Heritage Academy Christian School

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