Dear Grade 7 Teacher: One of your Grade 7 students has applied to our school’s Pre-AP/Incentive Program. Therefore, would you please be so kind as to complete and return this form as soon as possible to the student in a sealed envelope with your signature overlapping the seal? Students must bring the sealed envelope with them to their Math and English entrance exams on Wednesday, February 13, 2019. Alternatively, you may complete this form electronically at https://palmerincentive.com/application-procedure/incentive-8/grade-7-teachers-reference-form/The completed electronic form must then be saved and subsequently emailed from your (teacher’s) school-based email account (NOT a personal email account) to awong@sd38.bc.ca by Friday, February 22, 2019.

Student’s Name:________________________________________________________________ Last Name First Name

School:________________________________________________________________________

A. Please check the boxes that best represent the student:

Below Average Above Outstanding Average Average Achievement Profile Reading Comprehension…………

Math Skills…………………………. Written Expression………………..

Problem Solving…………………..

Social Science…………………….

Science Concepts/Skills………….

Behavioral Profile Curiosity……………………………

Accepts Challenge………………..

Creativity…………………………...

Social Interaction………………….

Task Commitment…………………

Self-Motivation…………………….

Risk-Taking………………………..

Enthusiasm………………………..

Leadership Potential……………..

R.C. PALMER INCENTIVE PROGRAM

Grade 7 Teacher’s Reference Form

B. Out of all the students whom you have taught, please indicate how highly you would rank this applicant overall (check one only):

In the top:

5% 10% 15% 20%

25% 30% 40% 50%

Below the top 50%

Please estimate the number of students you have taught over your teaching experience: _____________

C. Would you say that this student is suited for an accelerated and enrichment academic program? (Check one only)

Yes No Maybe

Please explain briefly (especially if you feel there are any areas of concern):

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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Teacher’s Signature: _____________________________________

Teacher’s Name (Print): _____________________________________

Date Completed: _____________________________________

Thank you for taking the time and effort to complete this form!

Revised Dec.2019