Confidential Language Reference

To be completed by the applicant’s language teacher
(Please type)

To be completed by the Applicant: Name:

Nine-month Language Program Summer Language Program

Hindi Bengali Tamil other (specify)

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Signature Date

To be completed by the Referee:

Please list the language courses that the applicant has taken with you:

Course title Dates of attendance Grade

Language ability:

For each section below, please use the following key:
A = above average B = average C = below average ? = information not available

Speaking:

1. Utilization of phonological distinctions (vowel length, aspiration, retroflexion, etc)
2. Command of vocabulary
3. Application of grammatical rules
4. Overall fluency
5. Comments:

Confidential Language Reference

(page two)

Listening:

1. Recognition of phonological distinctions
2. Command of vocabulary
3. Ability to follow normal rate of speech
4. Comments:

Reading:

1. Knowledge of script
2. Ability to give exact translation
3. Ability to read rapidly and grasp general content
4. Comments:

Writing:

1. Ability to handle script
2. Ability to produce standard written form of the language
3. Ability to take dictation
4. Comments:

PLEASE STATE THE BASIS OF YOUR EVALUATION:

Language assessment:

In terms of your personal knowledge of the applicant, please assess the applicant’s background, performance, and potential for progress in this language, identifying strengths and weaknesses that may be taken into account in the instructional program. If this form provides insufficient space, please feel free to use additional pages.