2017 Scientific Discover Program

Teacher Recommendation Form

INSTRUCTIONS: This form is part of the application packet for the Scientific Discover Program 2017. It is to be filled out by a teacher and submitted directly to the Project Director. Teacher recommendations not submitted online must be signed and dated. Deadline is April 21, 2017 or as soon as possible thereafter.

Dear Teacher: Your time and effort in answering the following questions will be greatly appreciated. All information will be kept in strict confidence.

Fields with an asterisk(*) are required.           Printable Version

Student Information

Student's Last Name*

First Name*




  Excellent Good Fair Poor Inadequate Information


Ability to work with other students*

Seriousness as a student*

Ability to work independently*


Willingness to cooperate*



Respect for adults*

Attitude toward learning*

Ability to successfully complete a long term project*

Interest in Math*

Interest in Science*

*Does the student have a "C" or better average in science or math in the latest grading period?   Yes   No

     If yes, please provide the most recent grade in: Math   Science   Technology

*In summary, applicant is:
Highly recommended   Recommended   Questionable   Not recommended  

Please characterize both the student's performance in science and math classes as well as his/her potental in science and mathematics.
How much support will the parent or guardian provide to ensure the student's success?
Great deal Some None Unable to judge
How well do you think that the student will do in this program? If there are any weak areas, how would you strengthen these?
Would you be willing to provide an opportunity for the student to present a research paper to a class during the academic year following this program?

Please indicate below any general recommendations that you may have about the student or any special considerations that you feel we should be aware of.
Please comment briefly on student's special interests, abilities, needs, or qualities


Teacher Information

Teacher's name*

Subjects taught and grade level*


School district number*

School address*

  City*  State*   Zip* 

Your email address at school