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Confidential. Student s Name Student s Current Grade: Parent s Signature Date Teacher s Name To the Teacher: The above named student has applied to a program offered at OASIS NC. Please provide a brief assessment of the student. Your evaluation will be given full consideration and will be kept confidential. Thank you for your time and effort in completing this form. Unable to Rate Academic Potential Reading Writing Math Science Motivation Attention Cooperation Respect for Authority.

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