This survey is for teachers, counsellors, educators, etc. to provide a referral for students who register for CORE programs. Please provide as much detail as possible based on your professional experience with the student.

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1. Student Information

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2. Referee Information

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4. Your Role/Title and Place of Work

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5. In what capacity did you work with the student? Please describe the nature of your relationship.

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6. Please share any insights about the student’s learning needs. Are there specific areas where they could use extra support or face challenges? Include as much detail as possible.

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7. What approaches or strategies have been effective in supporting this student’s learning?

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8. How would you describe the level of support this student requires?

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9. Are there any contextual factors (e.g., access to resources, language, family circumstances) that CORE should consider when supporting this student? (Optional)

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10. Anything else you'd like us to know about the student?

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11. Do you consent to CORE contacting you for follow-up if needed?

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