9775 SW 87 AVENUE, MIAMI, FLORIDA 33176

SCHOOL ADMINISTRATOR RECOMMENDATION

GRADES 6 -12

This form is to be completed by the school headmaster, principal, assistant headmaster, assistant principal,
dean of students, or guidance counselor. The parent(s)/guardian(s) of the applicant authorize the release of
requested information.

Name of Applicant Entering Grade

Name of Parent/Guardian

Signature of Parent/Guardian Date

ABOUT THE APPLICANT

Please rate the applicant on the following:

Academic Promise
Exceptional Good Average Poor

Integrity
Exceptional Good Average Poor

Influence on Peers
Positive Neutral Negative

Emotional Stability
Well Balanced Mostly Well Balanced Excitable Apathetic

Leadership Potential
Exceptional Good Average Poor

Moral Character
Exceptional Good Average Poor

Study Habits
Exceptional Good Average Poor
Has this student ever violated school policy (conduct, drug, alcohol, etc.) Yes No

Has this student ever been suspended or expelled? Yes No

Please explain if you answered yes to either of the questions above.

Is this student invited to re-enroll in your school next term? Yes No

ABOUT THE PARENTS

Do the parents support your schools initiatives and mission?

Always Most of the time Rarely Never

Do the parents meet their financial obligation?

Always Most of the time Rarely Not applicable

Do the parents participate in school functions and events?

Always Most of the time Rarely Never

Riviera thanks you for completing this form and helping evaluate this applicant. In order to expedite the
admissions process, please complete the information below and return this form directly to:

Riviera Preparatory School

Attn: Admissions Department
9775 SW 87 Avenue
Miami, FL 33176

You may also email to admissions@rivieraschools.com.

This information is confidential and will not be disclosed to the applicant.

Signature Title

Printed Name Date

Email Address Phone

School Name