Principle Application PRINCIPAL’S REPORT ON APPLICANTStudent’s Name(Required) First Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country NOTE: Principals are requested to complete the sections in this form. When completed, please send directly to the address above. All information and recommendations will be kept confidential. Thank you for your cooperation.LIMUDEI KODESH DEPARTMENTClass Rank Top Third Middle Third Bottom Third Subject: גמרא (הבנה)Final Marks Last JuneMost Recent Marking PeriodSubject: גמרא (קריאה)Final Marks Last JuneMost Recent Marking PeriodSubject: הלכהFinal Marks Last JuneMost Recent Marking PeriodSubject: חומשFinal Marks Last JuneMost Recent Marking PeriodSubject: נביאFinal Marks Last JuneMost Recent Marking PeriodPlease comment on the student’s performance in the following areas.A) Areas of StrengthB) Intellectual CapabilitiesC) Diligence & EffortD) Commitment to ReligionE) Midos & PersonalityF) Familial InfluenceAdditional CommentsSignature, Limudei Kodesh Department Principal(Required)Date MM slash DD slash YYYY GENERAL STUDIES DEPARTMENTClass Rank Top Third Middle Third Bottom Third Subject: EnglishMost Recent Marking PeriodFinal Marks Last JuneSubject: Social StudiesMost Recent Marking PeriodFinal Marks Last JuneSubject: MathMost Recent Marking PeriodFinal Marks Last JuneSubject: ScienceMost Recent Marking PeriodFinal Marks Last JunePlease mark the appropriate spaces below:Attendance Excellent Good Average Below Average Unsatisfactory Behavior Excellent Good Average Below Average Unsatisfactory Intellectual Abilities Excellent Good Average Below Average Unsatisfactory Leadership Excellent Good Average Below Average Unsatisfactory Motivation Excellent Good Average Below Average Unsatisfactory Relationships to Students Excellent Good Average Below Average Unsatisfactory Work Habits Excellent Good Average Below Average Unsatisfactory Scholastic AbilityIQ ScoreName of TestDate Administered MM slash DD slash YYYY Standardized Test Results: MathTypeAdministered in GradeGrade EquivalentStandardized Test Results: ReadingTypeAdministered in GradeGrade EquivalentPlease describe any personal circumstances which may require attention or should be taken into account in interpreting the applicant’s record.I hereby certify that the information given in this application is complete and accurate.Signature, General Studies Department Principal(Required)Date(Required) MM slash DD slash YYYY
