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Reference Letter
Please fill out the following for the Student Applicant. We appreciate it!
Student Applicant Information:
*
Indicates required field
Student Applicant First Name
*
Student Applicant Last Name
*
Student Applicant Date of Birth
*
Referee Information
(to be completed by a Referee who is well acquainted with the character traits of the Student Applicant)
Today's Date
*
Referee First Name
*
Job Title
*
Referee Last Name
*
Referee Phone Number
*
Referee Email Address
*
May we contact you about the Student Applicant?
*
Yes
No
What is the capacity that you know the Student Applicant and for how long?
*
Student Applicant Character Traits:
What would you say is the Student Applicant's greatest character strength?
*
What would you say is the Student Applicant's character strength requiring the most improvement?
*
Please describe what you believe motivates the Student Applicant with an example of proof?
*
A21 Academy Character Principles
Please complete 1-7 by choosing the most appropriate level for each criterion:
1. Respect & Compassion
2. Grit
3. Conscious Choice
Student is always respectful and compassionate towards self and others:
*
Exceptionally Beyond Standard - 5
Meets Standard- 4
Approaching Standard - 3
Below Standard - 2
Unknown - 1
Student is armed with a sense of passion, perseverance & heart - displaying grit.
*
Exceptionally Beyond Standard - 5
Meets Standard- 4
Approaching Standard- 3
Below Standard- 2
Unknown -1
Autonomous, self-directed and able to make conscious decisions
*
Exceedingly Beyond Standard- 5
Meets Standard - 4
Approaching Standard - 3
Below Standard - 2
Unknown - 1
4. Resilience
5. Character
6. Courteous Honesty
Able to use social and emotional intelligence in the face of challenge or change
*
Exceedingly Beyond Standard- 5
Meets Standard- 4
Approaching Standard - 3
Below Standard - 2
Unknown - 1
Academics and athletics are valued to develop presence, mental, emotional strength and character
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Exceedingly Beyond Standard - 5
Meets Standard - 4
Approaching Standard - 3
Below Standard - 2
Unknown - 1
Admirable and helpful with courteous candor and honesty
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Exceedingly Beyond Standard- 5
Meets Standard - 4
Approaching Standard - 3
Below Standard - 2
Unknown - 1
7. Altruistic
Altrutistic, compassionate towards others and actively seeks opportunity to serve community, global and universal issues.
*
Exceedingly Beyond Standard - 5
Meets Standard - 4
Approaching Standard - 3
Below Standard - 2
Unknown - 1
Confidentiality Agreement
T
he Applicant and/or all legal guardians/parents/referees shall hold and maintain confidential information in strictest confidence for the sole and exclusive benefit of A21 Academy Prep. The Student Applicant and/or all legal guardians/parents shall not, without prior written approval of A21 Academy Prep, publish, copy, or otherwise disclose to others, information pertaining to the application, registration, evaluations or offer sheet. Failure to uphold the policies and the non-disclosure agreement will necessitate immediate dismissal of the Student Applicant from A21 Academy Prep.
Thank you for your reference!
By Placing your initials in the box, you are signing this form. Please submit using the button and have a great day.
Electronic Initials
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Academics
Parent Reviews
A21 Course Calendar & Principles
A21 Eagles
Home
Hockey
Girls U19 Hockey Roster 2022/23
Girls Prep
HOCKEY SCHEDULES
BOYS U18 HOCKEY ROSTER 2022/23
BOYS U16 Hockey Roster 2022/23
Camps & Tryouts
Hockey Coaches
Alumni
facility
Contact
A21 Application
Golf
Parent Portal