The Eddy School
8 Bear River Road
Newry, ME 04261
Deb Webster, Director
Student's Name: ___________________________________________________________
Dear Parent/Guardian: Please sign the statement of confidentiality listed below, and give this form and a stamped return envelope addressed to The Eddy School to the person who will be writing the recommendation. Email submission is also accepted: TheEddy2011@gmail.com
Statement of Confidentiality
I acknowledge that I waive my right to read the confidential recommendation form for the student listed above. I affirm that all information furnished on the recommendation received by The Eddy School administration will be held in the strictest of confidence and is not available to the applicant and/or his or her family.
Your insights about this student and your existing relationship with this family can help us ascertain if our school will meet their needs. Please feel free to send your responses electronically or to use another sheet of paper to elaborate on any of the following questions. Please return this form to The Eddy School as soon as possible.
In what manner do you know this child?
What three words initially come to mind when you think of this student?
In a small group setting, how would you rate this student’s interaction with peers? Please elaborate on your rating below.
5 4 3 2 1
Always considerate and Unable to act respectfully
appreciative of others' towards peers
strengths and weaknesses
What has your experience been with this family?
Not exclusive to academics, what do you believe to be this student’s greatest strength?
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Not exclusive to academics, what do you believe to be this student’s area of most needed growth?
Please attach any more information you would like to share to this form.
I recommend this applicant to The Eddy School...
□enthusiastically □with confidence □with some reservation □with considerable reservation □do not recommend
Your name: _________________________________________ Title: ___________________________________
School: ________________________________________________School Address: _____________________________
City: _____________________________ State: _______ Zip: ____________ Telephone:__________________________
Thank you for completing this form. Your generosity with your time is greatly appreciated. Please contact Deb Webster, Director/Lead Teacher of The Eddy School with any comments or questions: TheEddy2011@gmail.com
In accordance with Federal Law and USDA Policy, this school does not discriminate on the basis of race, color, national origin, sex, age or disability (not all prohibited bases apply to all programs).