Reference Form – TeacherVeronica Jesuthasan2019-06-28T15:29:45+00:00 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands 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 APPLICABLETRAINING AND ATTITUDESPossesses a sound academic background in the subject areas that he/she has taught* 1 2 3 4 5 Don't Know Not Applicable Is well trained in basic teaching skills and methodology* 1 2 3 4 5 Don't Know Not Applicable Is skilled at developing individual lesson plans* 1 2 3 4 5 Don't Know Not Applicable Is willing to listen to and implement new ideas* 1 2 3 4 5 Don't Know Not Applicable Is able to use textbooks as a guide rather than the rigid determiner of particular courses* 1 2 3 4 5 Don't Know Not Applicable Demonstrates the maturity of approach and personality that would be expected in an experienced teacher.* 1 2 3 4 5 Don't Know Not Applicable Has a well developed philosophy of education* 1 2 3 4 5 Don't Know Not Applicable CLASSROOM STYLEPrepares well for his/her lessons* 1 2 3 4 5 Don't Know Not Applicable Can cope with a wide range of ability levels within the same class* 1 2 3 4 5 Don't Know Not Applicable Creates an attractive and stimulating teaching environment* 1 2 3 4 5 Don't Know Not Applicable Has a varied and productive teaching style* 1 2 3 4 5 Don't Know Not Applicable Encourages students to explore and problem-solve for themselves* 1 2 3 4 5 Don't Know Not Applicable Handles discipline fairly and firmly but with a sensitivity to individual students* 1 2 3 4 5 Don't Know Not Applicable Motivates students to be enthusiastic about their work* 1 2 3 4 5 Don't Know Not Applicable Is respected by his/her students* 1 2 3 4 5 Don't Know Not Applicable Is able to incorporate CAL (computer-assisted-learning) into his/her teaching program* 1 2 3 4 5 Don't Know Not Applicable Incorporates audio-visual media into his/her teaching program* 1 2 3 4 5 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* 1 2 3 4 5 Don't Know Not Applicable CONTRIBUTION TO SCHOOL LIFEIs involved in extra-curricular activities with students* 1 2 3 4 5 Don't Know Not Applicable Has an appropriate respect for authority structures* 1 2 3 4 5 Don't Know Not Applicable Maintains friendly and supportive relations with his/her fellow teacher* 1 2 3 4 5 Don't Know Not Applicable Works well as part of a team* 1 2 3 4 5 Don't Know Not Applicable Establishes and maintains good relationships with the parents of his/her students* 1 2 3 4 5 Don't Know Not Applicable MULTI-CULTURAL FACTORSWorks well in a multi-ethnic classroom where students come from many different countries/cultures* 1 2 3 4 5 Don't Know Not Applicable Works well in a multi-ethnic classroom where students come from many different countries/cultures* 1 2 3 4 5 Don't Know Not Applicable Has demonstrated an ability to work with a multi-ethnic staff* 1 2 3 4 5 Don't Know Not Applicable Is able to develop lessons in a thematic or conceptual framework (as opposed to prescribed content approach)* 1 2 3 4 5 Don't Know Not Applicable Incorporates community values into the subjects of the curriculum* 1 2 3 4 5 Don't Know Not Applicable Possesses adequate experience to work in a location where there are few other teachers teaching the same subject/grade* 1 2 3 4 5 Don't Know Not Applicable BACKGROUND AND SUMMARYPlease 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)B) Please write down the two areas related to teaching in which the applicant is in most need of development.A) B)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 MM slash DD slash YYYY
