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Student Reference Form For Admission to P1– P4

TISA P1-P4 Student Reference Form - The International School of ...

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THE INTERNATIONAL SCHOOL OF AZERBAIJAN<br />

TISA-AIOC | c/o BP Azerbaijan<br />

Chertsey Road | Sunbury-on-Thames | Middlesex | TW16 7LN | UK<br />

Tel: (994) 12 497 30 28 | admissions@tisa.az | www.tisa.az<br />

The TISA Mission is <strong>to</strong> prepare students <strong>to</strong> become life-long learners and positive contribu<strong>to</strong>rs <strong>to</strong> their local and global<br />

communities. TISA will prepare its students for the next stage of their education through a high quality, well-balanced<br />

educational programme. TISA will deliver its programme according <strong>to</strong> the universally recognised educational principles,<br />

practices and beliefs of the International Baccalaureate.<br />

<strong>Student</strong> <strong>Reference</strong> <strong><strong>For</strong>m</strong><br />

<strong>For</strong> <strong>Admission</strong> <strong>to</strong> <strong>P1–</strong> <strong>P4</strong><br />

The student whose name appears below has applied for admissions <strong>to</strong> The International School of Azerbaijan<br />

(TISA). This reference is an important part of the application and your cooperation in providing a full and candid<br />

report will be greatly appreciated.<br />

Please return this form directly <strong>to</strong> our <strong>Admission</strong>s Office via email: admissions@tisa.az<br />

Name of student:<br />

Current grade /<br />

year level:<br />

Name and address of school currently attended:<br />

Length of time working <strong>to</strong>gether with the student:<br />

Physical<br />

Development<br />

Gross mo<strong>to</strong>r skills<br />

Area of strength Age Appropriate Developing Area of Concern<br />

Fine mo<strong>to</strong>r skills<br />

Pencil grip<br />

Participation in<br />

physical activities<br />

Sense of body in<br />

space<br />

Clarity of speech<br />

1


THE INTERNATIONAL SCHOOL OF AZERBAIJAN<br />

TISA-AIOC | c/o BP Azerbaijan<br />

Chertsey Road | Sunbury-on-Thames | Middlesex | TW16 7LN | UK<br />

Tel: (994) 12 497 30 28 | admissions@tisa.az | www.tisa.az<br />

The TISA Mission is <strong>to</strong> prepare students <strong>to</strong> become life-long learners and positive contribu<strong>to</strong>rs <strong>to</strong> their local and global<br />

communities. TISA will prepare its students for the next stage of their education through a high quality, well-balanced<br />

educational programme. TISA will deliver its programme according <strong>to</strong> the universally recognised educational principles,<br />

practices and beliefs of the International Baccalaureate.<br />

The student demonstrates self discipline.<br />

The student follows directions<br />

The student responds positively <strong>to</strong> the<br />

challenge of academic work.<br />

The student is able <strong>to</strong> follow classroom<br />

discussions and participates willingly<br />

The student is able <strong>to</strong> express him/herself<br />

clearly<br />

The student is respectful and courteous<br />

<strong>to</strong>wards peers and adults.<br />

The student displays a well balanced<br />

temperament.<br />

The student is able <strong>to</strong> work independently for an<br />

age appropriate period of time.<br />

The student cooperates with others during<br />

group activities.<br />

The student exhibits age appropriate<br />

study habits and organizational ability.<br />

The student makes good friends<br />

Never Occasionally Usually Always<br />

Please any additional comments:<br />

2


THE INTERNATIONAL SCHOOL OF AZERBAIJAN<br />

TISA-AIOC | c/o BP Azerbaijan<br />

Chertsey Road | Sunbury-on-Thames | Middlesex | TW16 7LN | UK<br />

Tel: (994) 12 497 30 28 | admissions@tisa.az | www.tisa.az<br />

The TISA Mission is <strong>to</strong> prepare students <strong>to</strong> become life-long learners and positive contribu<strong>to</strong>rs <strong>to</strong> their local and global<br />

communities. TISA will prepare its students for the next stage of their education through a high quality, well-balanced<br />

educational programme. TISA will deliver its programme according <strong>to</strong> the universally recognised educational principles,<br />

practices and beliefs of the International Baccalaureate.<br />

Have there been any disciplinary, emotional or other concerns regarding this student? Yes / No<br />

If yes, please explain.<br />

Please list any conditions the student has been diagnosed with, e.g. dyslexia, dyspraxia, ADD, ADHD / or is<br />

currently referred for:<br />

Do you have any concerns in particular about this child? Yes / No<br />

If yes, please give further details<br />

3


THE INTERNATIONAL SCHOOL OF AZERBAIJAN<br />

TISA-AIOC | c/o BP Azerbaijan<br />

Chertsey Road | Sunbury-on-Thames | Middlesex | TW16 7LN | UK<br />

Tel: (994) 12 497 30 28 | admissions@tisa.az | www.tisa.az<br />

The TISA Mission is <strong>to</strong> prepare students <strong>to</strong> become life-long learners and positive contribu<strong>to</strong>rs <strong>to</strong> their local and global<br />

communities. TISA will prepare its students for the next stage of their education through a high quality, well-balanced<br />

educational programme. TISA will deliver its programme according <strong>to</strong> the universally recognised educational principles,<br />

practices and beliefs of the International Baccalaureate.<br />

How do you think the student will manage transition <strong>to</strong> a new school?<br />

Parents involvement and support:<br />

Are the parents supportive of the programs and policies of the school? Yes / No<br />

Are the parents supportive of their child’s educational process Yes / No<br />

_____________________________________________________________________________________________<br />

Would you like <strong>to</strong> give us further information over the telephone: Yes / No<br />

Name:<br />

Position:<br />

Email:<br />

Telephone:<br />

Signature:<br />

Best time <strong>to</strong> call:<br />

Date:<br />

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