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*

Is well trained in basic teaching skills and methodology*

Is skilled at developing individual lesson plans*

Is willing to listen to and implement new ideas*

Is able to use textbooks as a guide rather than the rigid determiner of particular courses*

Demonstrates the maturity of approach and personality that would be expected in an experienced teacher.*

Has a well developed philosophy of education*

CLASSROOM STYLE

Prepares well for his/her lessons*

Can cope with a wide range of ability levels within the same class*

Creates an attractive and stimulating teaching environment*

Has a varied and productive teaching style*

Encourages students to explore and problem-solve for themselves*

Handles discipline fairly and firmly but with a sensitivity to individual students*

Motivates students to be enthusiastic about their work*

Is respected by his/her students*

Is able to incorporate CAL (computer-assisted-learning) into his/her teaching program*

Incorporates audio-visual media into his/her teaching program*

When opportunity arises to use equipment such as in a laboratory, he/she encourages students to experiment in a 'hands on' way*

CONTRIBUTION TO SCHOOL LIFE

Is involved in extra-curricular activities with students*

Has an appropriate respect for authority structures*

Maintains friendly and supportive relations with his/her fellow teacher*

Works well as part of a team*

Establishes and maintains good relationships with the parents of his/her students*

MULTI-CULTURAL FACTORS

Works well in a multi-ethnic classroom where students come from many different countries/cultures*

Has demonstrated an ability to work with a multi-ethnic staff*

Is able to develop lessons in a thematic or conceptual framework (as opposed to prescribed content approach)*

Incorporates community values into the subjects of the curriculum*

Possesses adequate experience to work in a location where there are few other teachers teaching the same subject/grade*

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

Reference Form – Teacher