Your Information
Regents Alternative Pathway to Iowa Licensure (RAPIL)Recommendation FormThe individual who provided you with this form is applying for the Regents Alternative Pathway to Iowa Licensure (RAPIL) and has the end goal of becoming a secondary education teacher. As part of the application process, we ask each applicant to identify three individuals with whom they have professional relationships to serve as a recommendation. This information will be used during the initial screening process of the application process.Your InformationApplicant’s Name:Your Name:Your Email Address:Your Professional Role/Title:Your Place of Employment:State & zip code:How do you know the applicant?EvaluationConsider the applicant in your professional relationship and as a future educator. Then respond to each statement by placing an “X” in the column that matches your response.ProfessionalismStatementNo Information0Strong Disagree1Disagree2Agree3Strong Agree4Regular and punctual attendanceCompletes assignments, projects and other work in a timely mannerResponds positively to constructive feedbackPositively communicates with colleagues Takes responsibility for own work and learningAccepts responsibility for errors or failures and seeks to rectifyDemonstrates good time management skillsExpresses an opportunity (vs problem) approach to challengesFocused on quality of work produced not simply completing a requirementEmbraces demanding work when purpose is relevant and/or importantFlexibilityStatementNo Information0Strong Disagree1Disagree2Agree3Strong Agree4Adapts to changeDeals appropriately with less than ideal situations when necessaryInterpersonal and Communications SkillsStatementNo Information0Strong Disagree1Disagree2Agree3Strong Agree4Effectively expresses ideas in oral communicationEffectively expresses ideas in written communication with appropriate attention to stylistic and compositional elementsEncourages others to participate and share their thoughtsRespectfully and actively listens to othersUses diplomacy and respectful language when addressing othersCan disagree in a positive and constructive wayProvides effective feedback to othersCollaboration and TeamworkStatementNo Information0Strong Disagree1Disagree2Agree3Strong Agree4Willingly contributes to group or team project workWilling to assume leadership roleEffectively communicates with team membersAssumes personal responsibility for quality of final project productInclusivenessStatementNo Information0Strong Disagree1Disagree2Agree3Strong Agree4Demonstrates inclusive attitudes and behaviorsPromotes the sharing of different perspectives and experiencesDoes not express or effect bias based on demographics such as gender, race, religion, ethnicity or sexual orientationAdditional commentsPlease provide any other information that would support us in reviewing this applicant:_____________________________________________________________________________________Submitting this formPlease return this form to the applicant (allowing them to view your recommendation) or send it to: Amy Mayeramy.mayer@uni.eduAuthorizationThank you for agreeing to serve as a reference for the applicant. Your recommendation will be kept confidential and the applicant will not have access to the information unless you give permission. I give my permission for the applicant to view my recommendation form. YES NOSignatureMy signature verifies that the information provided is accurate based upon by understanding of the applicant.Name (signature):Date: ................
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