PIA Integrated Arts

Making the Arts for real

Teacher Referral Form

Confidential Teacher Referral Form
(This form is confidential and will be submitted directly to the PIA program via the internet. Grade 8 teachers or other past teachers of student applicants should complete these forms. A paper version of the form is also available and may be submitted in confidence directly to PIA c/o TAS.) 
Each applicant to the program is required to have TWO teachers each submit one of these forms to support his/her application.
For the following questions 1 is LOW and 10 is HIGH*1. How would you rate this student's creative ability?
1  2  3  4  5  6  7  8  9  10  
*2. How would you rate this student's ability to show enthusiasm and energy towards a creative task?
1  2  3  4  5  6  7  8  9  10  
*3. How would you rate this student's ability to use an imaginative approach to tasks presented?
1  2  3  4  5  6  7  8  9  10  
*4. How would you rate this student's academic ability?
1  2  3  4  5  6  7  8  9  10  
*5. How would you rate this student's ability to generate original ideas?
1  2  3  4  5  6  7  8  9  10  
*6. How would you rate this student's behaviour?
1  2  3  4  5  6  7  8  9  10  
*7. How would you rate this student's attitude toward school?
1  2  3  4  5  6  7  8  9  10  
*8. How committed do you think this student would be to the arts program?
1  2  3  4  5  6  7  8  9  10  
*9. How well can this student accept constructive criticism?
1  2  3  4  5  6  7  8  9  10  
*How well does this student work in groups?
1  2  3  4  5  6  7  8  9  10  
*11. How willing is this student to take risks?
1  2  3  4  5  6  7  8  9  10  

*13. Select the most appropriate response regarding this student's attendance pattern.
Outstanding  Consistent  Misses a lot of school  


*16. How strongly do you feel this student should be part of the Integrated Arts Program?
Not a strong candidate  Could do well  Must be accepted  
Thank you for completing this student referral. Please click submit to send the form electronically.
If the student is applying to take Music, a music teacher must complete the confidential Music Referral Form.

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