GUID-FRM-004

00

1946

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. 723-0522

E-mail Add: guidance@spuqc.edu.ph

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: _______________________________________________________________
st

College Program Applied for: 1 __________

nd

__________ Grade/ Year Level Applied for: ________

Complete Name of Current/Last School: ____________________________________________________________

Complete School Address: _______________________________________________________________________

______________________________
Applicants 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 him/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 RECOMMENDERS ASSESSMENT

Below
Average

Average

Above
Average

No Basis

_______________________________________________________________________________________________________________________

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

2.

Period Covered

__________________________________________________________________

__________________________

__________________________________________________________________

__________________________

__________________________________________________________________

__________________________

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

teachers 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 students recommendation form.

All ratings, responses and recommendations in this form and attachments are regarded as confidential.

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Caritas Christi Urget Nos!

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