2010 Recommendation Form

Thank you for taking the time to complete Horizon Arts Camp's online Recommendation Form. The H.A.C. program has a unique structure and recommendations are used to assess whether our approach is the right fit for the camper being considered. The Camp strives to set all our campers up for success and we thank you for participating in this process. If you have any questions or concerns please contact Myanna Adams, Assistant Camp Director at 416-558-0922 or myanna@horizonartscamp.org. 

Please ensure you fill out the entire form - incomplete forms cannot be submitted.

First & Last Name of the child you are recommending:
Referee First & Last Name:
Position/Title:
Name of Organization/School:
Address:
City:
Province:
Postal Code:
Phone Number:
Email Address:
How long have you known the child?
In what capacity do you know/work with the child (i.e., you are their teacher, coach, they attend a program you run etc.):
What are the main strengths of the child?
What are the areas of improvement for the child?
Are there behavioural problems at home or at school that you are aware of?
Yes No
If YES, please explain:
Is the child experiencing stressful or difficult life situations (divorce, death in the family, family job loss etc.) that you are aware of?
Yes No
If YES, please explain:
Does the child have any of the following (check all that apply):
ADD/ADHD Learning Disabilities Autism Spectrum Disorder Epilepsy Diabetes Mental Health Concerns Physical Challenges (i.e., vision impairment, chronic injury, medical condition, etc.) History of Abuse/Domestic Violence Other None of the above
If you selected any of the above please explain
Please indicate where you feel this child ranks in the categories listed below.
Creativity/Originality:	Please select Can Improve Good Very Good Excellent Unknown
Works co-operatively with peers & adults:	Please select Can Improve Good Very Good Excellent Unknown
Motivation (work ethic) & Enthusiasm:	Please select Can Improve Good Very Good Excellent Unknown
Attendance & Punctuality:	Please select Can Improve Good Very Good Excellent Unknown
Leadership Potential:	Please select Can Improve Good Very Good Excellent Unknown
Demonstrates an active interest in the arts:	Please select Can Improve Good Very Good Excellent Unknown
Demonstrates a positive attitude towards learning:	Please select Can Improve Good Very Good Excellent Unknown
Existing skill level in music:	Please select Can Improve Good Very Good Excellent Unknown
Existing skill level in theatre:	Please select Can Improve Good Very Good Excellent Unknown
Existing skill level in dance:	Please select Can Improve Good Very Good Excellent Unknown
Existing skill level in visual arts:	Please select Can Improve Good Very Good Excellent Unknown
How would the child benefit from participation in Horizon Arts Camp?
Please use the space below to provide any additional information you would like to share about the child you are recommending to Horizon Arts Camp:
In submitting this form you are confirming that all of the statements made in this recommendation are true to the best of your knowledge. Please note that you may receive a phone call from our Assistant Camp Director verifying the statements made in this form.
Accept