Academic Teacher Reference | Arts Mackenzie Application
Thank you for supporting your student's application to Arts Mackenzie by completing this academic reference. No paper copy of this reference is required.  Please e-mail arts.alexandermackenzie@yrdsb.ca with any questions related to the reference form.
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Email *
Student's name *
Discipline Student Is Applying For?
Clear selection
Your name *
Your phone number *
Your position *
How long have you known the student and in what capacity? *
Characteristics
Please rate the student according to the following criteria:
Academic Progress *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Academic Progress
Academic Potential *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Academic Potential
Personal Initiative *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Personal Initiative
Demonstrates Respect *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Demonstrates Respect For Self, Others and the School Community
Leadership *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Leadership Ability
Works Independently *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Works Independently
Accepts Responsibility *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Accepts Responsibility
Integrity *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Integrity
Emotional Maturity *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Emotional Maturity
Time Management *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Time Management
Social Interaction *
Outstanding (Top 5%)
Good (Top 25%)
Average
Below Average
Unsure
Social Interaction
Additional Comment Section
In questions 1 and 2, please pick the answer that coincides with your opinion of the applicant.  Feel free to add comments if you wish.
Question 1
This student will succeed in a demanding, self-directed program.  
Opinion Question 1 *
I strongly agree
I agree
I disagree
I strongly disagree
I am unsure
Pick the answer that coincides with your opinion of the applicant.
Additional Comments Question 1
Question 2
This student demonstrates a passion for the arts.  
Opinion Question 2 *
I strongly agree
I agree
I disagree
I strongly disagree
I am unsure
Pick the answer that coincides with your opinion of the applicant.
Additional Comments Question 2
Any Additional Information
Do you have any additional information you would like to add pertaining to the student’s application?
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