Confidential Character Reference
Dear Referencing Teacher,
Thank you for taking the time to fill out this Confidential Character Reference. Your input is greatly appreciated. The information you provide will be used help us understand the needs and strengths of the student applying to the Integrated Arts Program. It will help us to assess whether or not this student is a good fit for the IAP. Please answer each question to the best of your ability by the application due date, January 16, 2020. If you have any questions, please contact the Arts Registrar at 519-743-8265 x5591 or at
Student's Last Name
Your answer
Student's First Name
Your answer
Student's OEN
Your answer
Referencing Teacher
Your answer
Your answer
Student's Current Grade
1. How long have you known the student?
Your answer
2. What do you consider to be the student's strengths?
Your answer
3. Has the student been diligent in their studies?
Your answer
4. Does this student have any special emotional, physical, or academic needs that you feel we should know about?
Your answer
5. What extracurricular activities is the student involved in at school and in the community?
Your answer
6. Do you think this student will have difficulty integrating into a new peer group at Eastwood? Please explain?
Your answer
Part B.
Please rate the student on the items below. Comments are welcome.
Not able to observe
Respect for Authority
Initiative and Perseverance
Integrity and Honesty
Organizational Skills
Intellectual Curiosity
Shows Deference to Others
Part B. Comments:
Your answer
Part C.
Relationships with Peers: Please check all that apply (to best of your knowledge)
Part C. Comments:
Your answer
Given the above, please give specific reasons why you think or do not think this student should be considered for the Integrated Arts Program:
Your answer
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