Student Evaluation Form

American Youth Leadership Program – Thailand

Student Evaluation Form

Thank you for taking the time to evaluate your student for consideration in the American Youth Leadership Program (AYLP) for Thailand. The program consists of a six-month preparation period, January-June 2016, and a nearly one month program throughout Thailand. More information on the program – and an electronic version of this form -- can be found on our website at the Mansfield Center Website.

Please submit this by email, directly from your e-mail account to Kelsey Stamm: . You will receive a confirmation email following submission. Please contact Kelsey if you have not received a confirmation within two days of submission: 243-2838.

SECTION TO BE COMPLETED BY STUDENT APPLICANT

Applicant’s name:

High school:

Town:

Telephone:

Email:

SECTION TO BE COMPLETED BY HIGH SCHOOL TEACHER, COUNSELOR, OR ADMINISTRATOR

Name:

Subject taught/School role:

High school:

Town:

Telephone:

Email:

1.  How long have you known the student, and in what capacity?

2.  Each student will have challenges in Thailand due to the nature of the program. Challenges might include: difficulties with the heat, the food, group integration, lack of communication, showing respect for Thai partners or group members, or exhibiting a sense of entitlement or self-focus when having to accommodate others. Please list the challenges that this student might face as part of the program and how the experience might help him/her to grow.

3.  Please indicate your perceptions of the student’s competence in the following areas, ranking them as below average, average, above average, outstanding, or unable to rate.

a.  Strong academic motivation:

b.  Intellectual curiosity:

c.  Self-discipline:

d.  Stress tolerance:

e.  Emotional stability:

f.  Personal/social maturity:

4.  In your experience, how does this student react to stress and physically and/or emotionally uncomfortable situations?

5.  What do you think this student would best contribute to the program and to fellow travelers?

6.  How do you think that this opportunity would most benefit the student?

7.  Is there anything else we should consider in reviewing this student’s application?

Signature: ______Date: ______

Thank you for your time in assisting both the student as well as the review committee.

Questions may be referred to Project Manager Kelsey Stamm at

or 406-243-2838.

4TH FLOOR MANSFIELD LIBRARY | UNIVERSITY OF MONTANA | MISSOULA, MT | 59801| (T) 406.243.2988 | (F) 406.243.2181

Attach additional pages as necessary.

This application is available at no charge and can be duplicated.

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