Reference Form – Wells Cathedral School

Reference Form

Pupil's Name *

Date of Birth *

Pupil's Unique Pupil Number (UPN) *

Is the pupil applying for one of our scholarships? *

Yes
No
Unsure

Scholarship Specific Information

To what extent do you think the pupil would be a suitable scholarship candidate in their chosen field? *

Very suitable
Somewhat suitable
Unsure
Unsuitable

Any comments on scholarship suitability *

Contribution to scholarship field(s): participation in teams/matches, productions, concerts, positions of responsibility… *

Please comment on the following regarding the above-named pupil.

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

Personal attributes, talents and interests: music, art, drama, sport, outdoor learning, other … *

Special support or differentiation needs: gifted/talented, special educational needs, English as an Additional Language.

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

Personal attributes and interests: music, art, drama, sport, favourite subjects, etc. *

Any comments in relation to issues with fee payment (if applicable) and relevant family circumstances etc.

Any other comments: family background, medical, attendance, length of time at current school, position in cohort, summary of potential.

Has this pupil been involved in behaviour which has required disciplinary measures (including, but not exclusively, temporary or permanent exclusion)? *

Yes
No

Please give details about this behaviour (we may follow up by telephone if appropriate). *

Test Data

Please provide the most recent test results as applicable.

Verbal Reasoning

Test Agency *

Date taken *

Standardised score *

Non Verbal Reasoning

Test Agency *

Date taken *

Standardised score *

Maths

Test Agency *

Date taken *

Standardised score *

English / Comprehension

Test Agency *

Date taken *

Standardised score *

Please include details of any further testing data you might have, including reading level *

Your Details

Your Name *

Your Position *

Your Email *

Name of School *

Are you willing for us to contact you if we'd like to ask you any additional questions? *

Yes
No

Contact number *

Signature *

Date *

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Email *

We are delighted that His Majesty King Charles III will remain the Patron of Wells Cathedral School.

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