Reference Form – Teacher

Reference Form - Teacher

Name of Applicant*
First Last
Name of Person Providing Reference*
First Last
Address of Person Providing Reference*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Please evaluate the applicant as fairly as you are able by marking your ratings on the following continuums. If you don't feel qualified to give an answer in a particular area, please mark it Don't Know or Not Applicable. Your responses will be kept confidential.
1 = POOR
2 = BELOW AVERAGE
3 = AVERAGE
4 = ABOVE AVERAGE
5 = OUTSTANDING
OR DON'T KNOW
NOT APPLICABLE
TRAINING AND ATTITUDES
Possesses a sound academic background in the subject areas that he/she has taught*
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- Don't Know
- Not Applicable
Is well trained in basic teaching skills and methodology*
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- Don't Know
- Not Applicable
Is skilled at developing individual lesson plans*
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- Don't Know
- Not Applicable
Is willing to listen to and implement new ideas*
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- Don't Know
- Not Applicable
Is able to use textbooks as a guide rather than the rigid determiner of particular courses*
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- Don't Know
- Not Applicable
Demonstrates the maturity of approach and personality that would be expected in an experienced teacher.*
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- Don't Know
- Not Applicable
Has a well developed philosophy of education*
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- Don't Know
- Not Applicable
CLASSROOM STYLE
Prepares well for his/her lessons*
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- Don't Know
- Not Applicable
Can cope with a wide range of ability levels within the same class*
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- Don't Know
- Not Applicable
Creates an attractive and stimulating teaching environment*
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- Don't Know
- Not Applicable
Has a varied and productive teaching style*
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- Don't Know
- Not Applicable
Encourages students to explore and problem-solve for themselves*
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- Don't Know
- Not Applicable
Handles discipline fairly and firmly but with a sensitivity to individual students*
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- Don't Know
- Not Applicable
Motivates students to be enthusiastic about their work*
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- Don't Know
- Not Applicable
Is respected by his/her students*
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- Don't Know
- Not Applicable
Is able to incorporate CAL (computer-assisted-learning) into his/her teaching program*
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- Don't Know
- Not Applicable
Incorporates audio-visual media into his/her teaching program*
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- Don't Know
- Not Applicable
When opportunity arises to use equipment such as in a laboratory, he/she encourages students to experiment in a 'hands on' way*
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- Don't Know
- Not Applicable
CONTRIBUTION TO SCHOOL LIFE
Is involved in extra-curricular activities with students*
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- Don't Know
- Not Applicable
Has an appropriate respect for authority structures*
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- Don't Know
- Not Applicable
Maintains friendly and supportive relations with his/her fellow teacher*
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- Don't Know
- Not Applicable
Works well as part of a team*
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- Don't Know
- Not Applicable
Establishes and maintains good relationships with the parents of his/her students*
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- Don't Know
- Not Applicable
MULTI-CULTURAL FACTORS
Works well in a multi-ethnic classroom where students come from many different countries/cultures*
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- Don't Know
- Not Applicable
Works well in a multi-ethnic classroom where students come from many different countries/cultures*
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- Don't Know
- Not Applicable
Has demonstrated an ability to work with a multi-ethnic staff*
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- Don't Know
- Not Applicable
Is able to develop lessons in a thematic or conceptual framework (as opposed to prescribed content approach)*
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- Don't Know
- Not Applicable
Incorporates community values into the subjects of the curriculum*
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- Don't Know
- Not Applicable
Possesses adequate experience to work in a location where there are few other teachers teaching the same subject/grade*
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- Don't Know
- Not Applicable
BACKGROUND AND SUMMARY
Please indicate the length of time and dates during which you have known the applicant in a professional capacity.*
What has been your professional relationship with this applicant (fellow teacher, Principal, etc.)*
What is the location (institution and city) in which you have known the applicant professionally?*
Please write down what you consider to be the applicant's two most outstanding talents or abilities as a teacher?
A)
B)
Please write down the two areas related to teaching in which the applicant is in most need of development.
A)
B)
Please add any other relevant comments which you think may be of assistance to us as we consider this applicant.
Would you hire this person again?*
Consent*
By checking this box, I agree that everything is true and accurate.
Signature (Name)*
Date
Date Format: MM slash DD slash YYYY

Reference Form – Teacher

Reference Form - Teacher

TRAINING AND ATTITUDES

CLASSROOM STYLE

CONTRIBUTION TO SCHOOL LIFE

MULTI-CULTURAL FACTORS

BACKGROUND AND SUMMARY