St Joseph's Confidential Reference Form - Year 12 - St Joseph’s CollegeSt Joseph’s College

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St Joseph’s Confidential Reference Form – Year 12

Student's Name *

First

Last

Name of current school *

Student's UPN (if applicable)

Address of current school *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone number of current school (in case of queries) *

Contact email address *

Attendance and behaviour

Attendance *

Very good
Good
Fair
Poor

Comment

Punctuality *

Very good
Good
Fair
Poor

Comment

Conduct *

Very good
Good
Fair
Poor

Comment

Effort *

Very good
Good
Fair
Poor

Comment

Predicted GCSE/iGCSE grades

English Language

English Literature

Maths

Subject 4 (name)

Subject 4 predicted grade

Subject 5 (name)

Subject 5 predicted grade

Subject 6 (name)

Subject 6 predicted grade

Subject 7 (name)

Subject 7 predicted grade

Subject 8 (name)

Subject 8 predicted grade

Subject 9 (name)

Subject 9 predicted grade

Subject 10 (name)

Subject 10 predicted grade

Subject 11 (name, if applicable)

Subject 11 predicted grade (if applicable)

Subject 12 (name, if applicable)

Subject 12 predicted grade (if applicable)

Suitability to study A levels and summary of potential? *

Attitudes to learning - application, motivation, behaviour, ability to work independently/in a group, intellectual curiosity and communication skills, ability to use ICT, organisational: *

Contribution to school life eg participation in teams/matches, productions, concerts, positions of responsibility: *

Personal attributes, talents and interests eg music, art, drama, sport, chess, other: *

Special support or differentiation needs - gifted/talented, special educational needs (Educational Psychologist or Specialist Assessor Reports, or other professional diagnoses, IEP’s, EHCP and Form 8 documentation, or similar), English as an Additional Language:

Receives any special consideration during exams?

Medical or disability needs: Have any health or medical conditions (including any medication) that we should be aware of?

Any behavioural issues including whether they have been subject to an internal/external exclusion that we should be aware of?

Any other comments - family background, or any other circumstances of which the school should be aware?

FOR INDEPENDENT SCHOOLS ONLY Please confirm that, to date, all fees have been paid.

Name of teacher completing this reference *

First

Last

Position of teacher completing this reference *

Name

1481