2021-2022

TC FORM 4
RECOMMENDATION
STUDENT NAME:
last name first name middle name
FROM TEACHER

School city: __________________ School name: _____________________________________

Current class (circle one): 8 9 10 11 12 Other: _______________________________

INSTRUCTIONS
TO STUDENT: Complete the information at the top of this form. Ask one of your teachers, who knows you well, to complete this form. If you cannot choose a teacher,
you may choose a school director or a teacher from a school you recently attended. This recommendation MUST be filled out in English and returned with your application.

IF THE RECOMMENDER KNOWS ENGLISH: IF THE RECOMMENDER DOES NOT KNOW ENGLISH:
• Give him/her Form 4. • Provide him/her with the instructions and questions translated into the recommender’s native language.
• Ask the recommender to follow the directions below. • Have the recommender’s answers translated into English on to Form 4.
• The translator must complete section 4.9.
• Both the Form 4 and the answers in the local language (if the original is not in English)
must be returned with the application.

TO RECOMMENDER: Please answer the questions and sign this document.Your answers to the questions on this form will be evaluated along with the student’s own
application materials to determine his/her suitability for this scholarship program. Therefore, we ask you to answer each question honestly, carefully and completely. Return
the completed form to the student, who will attach it as part of the application. This form must be filled out in English and have the school stamp.

4.1 Please describe this student’s behavior. How does the student respond to authority? How does he/she relate to peers and participate in group projects
with other students? What talents, interests and skills does this student have that will contribute to an international exchange experience? Please give examples.

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

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4.2 Please comment on the student’s motivation in school and study habits.

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________

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4.3 Please evaluate the student’s character in the following categories (check the appropriate boxes):
Personality Traits Excellent Above Average Average Below Average
Maturity  
 
Openness  
 
Leadership  
 
Ability to adapt to new situations  
 
Ability to interact with others  
 
Honesty  
 
Responsibility  
 
Respect for others  
 
Motivation  
 
Curiosity  
 
Knowledge of English (if known)  
 

Comments: ________________________________________________________________________________________
_________________________________________________________________________________________________
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2021-2022 FORM 4
TC RECOMMENDATION
FROM TEACHER
STUDENT NAME:
last name first name middle name

4.4 a. Has the student had any adjustment or disciplinary problems at school?  Yes  No
4.4 b. Has the student missed or repeated a year?  Yes  No
4.4 c. Does the student have a history of continuous or frequent absences from school?  Yes  No
4.4 d. Does the student currently have any special educational needs?  Yes  No
If you answered “yes” to any question, please explain:

4.5 How long have you known this student? Years:

4.7 Are you a teacher at the student’s high school?  Yes  No If no, explain:
_____________________________________________________________________________________________________________
4.8 Check one of the following and explain below:
 I feel this applicant is ready to become an exchange student.
 I have some reservations about this applicant’s readiness to become an exchange student.
 I do not recommend this applicant.

Please explain: ______________________________________________________________________________________________________

_ ________________________________________________________________________________________________________________

_ ________________________________________________________________________________________________________________

_ ________________________________________________________________________________________________________________

_ ________________________________________________________________________________________________________________

RECOMMENDER
Name of recommender: _ _____________________________________________________________________________________________
last name first name middle name
Position of recommender: _____________________________________________________________________________________________
Place of work: Country:
Region: City/Town:

SCHOOL STAMP (if no stamp, please explain):

SCHOOL
STAMP
REQUIRED

SIGNATURE OF RECOMMENDER: _____________________________________________________ Date: _______________

TRANSLATOR'S STATEMENT
4.9 This section must be filled out by the translator if the original recommendation is not in English.
I hereby certify that the above English translation is a true and accurate rendering of the original text, and I have included the original form.

Name of translator: _____________________________________________________________________________________________

SIGNATURE: _______________________________________________________________________________ Date: _______________