Program Code #_________________ (office use only)
Iona Catholic Secondary School
ARTS & CULTURE REGIONAL PROGRAM
APPLICATION PACKAGE
APPLICATIONS ACCEPTED – December 1st – 4st,2015 Iona Catholic Guidance office 8am-2pm
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PROGRAM SELECTION: Select the Arts and Culture area you are applying for.
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DANCE
INSTRUMENTAL MUSIC
VISUAL ART
Male
VOCAL MUSIC
(Portfolio due at time of the audition in January)
APPLICANT INFORMATION:
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DRAMA
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(Print Clearly)
Female
Name: ___________________________________________
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Last Name
First Name
Home Address: _____________________________________________________________________
City: ________________________________
Postal Code: _______________________
Home Telephone Number: ______________________________
Parents/Guardian’s Name: ____________________________________________________________
Last Name
First Name
Parent’s Work/Cell Number: __________________________________________________________
Work
Cell
Current Elementary School: _______________________________________
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Individual Education Plan (IEP)
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City: _____________
In the process of being identified (IPRC)
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ELL
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REGISTRATION PACKAGE CHECKLIST:
Please verify the following documentation is enclosed in order to receive an audition time.
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1. Application Form completed fully with a wallet size photo attached.
2. Student Information Form.
3. Parent/Guardian Recommendation Form.
4. Grade 8 Teacher Recommendation Form in a sealed envelope.
5. Photocopy of Grade 7 June Report Card and 8 Progress Report.
Attach
Photo
Here
6. Copy of the Individual Education Plan (IEP) if applicable.
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Program Code #_________________ (office use only)
Name: ______________________________________________________
Student Information Form
1. What activities have you participated in that show your interest and experience in the arts?
(school or extracurricular)
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2. What skills would you like to develop in your secondary school career? (Example: artistic,
future job skills, speaking skills, technical skills, computer skills, etc.)
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3. Explain why you are applying for Iona Catholic’s Arts and Culture Program.
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4. What are your education and career plans for the future?
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5. Is there anything else you would like us to know about you?
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Student Signature : ______________________________________________________
Parent Signature: ________________________________________________________
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Program Code #_________________ (office use only)
Parent/Guardian Recommendation Form
1. How would your child benefit from the Iona Arts and Culture Regional Program?
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2. How do you and your family feel about your child’s prospective involvement in the
program?
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3. Do you have any academic or artistic goals you would like your child to achieve?
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4. Are there any difficulties or special circumstances or health concerns your child has
experienced that we should be aware of in order to provide appropriate support? (i.e.
physical, emotional, academic, etc.)
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5. Is there anything else you would like us know about your child that would assist us?
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Parent/Guardian signature: ______________________________
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Program Code #_________________ (office use only)
IONA CATHOLIC SECONDARY SCHOOL
2170 South Sheridan Way (905) 823 0136
Arts and Culture Regional Program
Grade 8 Teacher Recommendation Form
This confidential form must be submitted within the student’s application package. Once completed,
place in a sealed envelope with your signature or school stamp across the seal and return to the
student. Or courier through the Dufferin-Peel courier addressed to Alice Howell at Iona Catholic or
email/scan directly to Alice Howell at alice.howell@dpcdsb.org.
Applications are being accepted from December 1-4, 2015. Thank you so much.
Applicant’s Name: ___________________________________________________
Last Name
First Name
Program Applying for:
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Dance
Instrumental Music
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Drama
Visual Arts
Vocal Music
Current School: _____________________________________________________
---------------------------------------------------------------------------------------------------------(Bottom Portion to be completed by current Grade 8 teacher).
Teacher’s Name: ____________________________________________________
Last Name
First Name
Date: __________________________________________
Please check one of the boxes below if applicable.
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IEP
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In the process of being identified
Excellent
Good
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ELL/ESL
Below Average
N/A
Leadership
Reliability
Emotional Maturity
Time Management
Social Interactions
Artistic ability in area selected
Adaptability to challenging situations
Ability to accept feedback
Attendance, punctuality
Academic ability
Additional information that would assist the interview panel.
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Teacher Signature ___________________________________________
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