SUBSTITUTE REFERENCE

To: ________________________________________________   

Applicant:  _______________________________________________

Position: ___________________________________________  


In the interest of providing the best education for the children of this district, please give your frank and honest opinion of the applicant. This information will be confidential.
Applicant’s Signature _________________________________

PERSONAL QUALITIES & CHARACTERISTICS

Please circle the categories which most appropriately describe the applicant.
5 = Clearly Outstanding    4 = Exceeds Expectations    3 = Satisfactory   
2 = Below Expectations    1 = Unsatisfactory

Appearance 5 4 3 2 1 Unknown
Attendance/punctuality 5 4 3 2 1 Unknown
Emotional stability 5 4 3 2 1 Unknown
Dependability 5 4 3 2 1 Unknown
Professional judgment 5 4 3 2 1 Unknown
Response to supervision 5 4 3 2 1 Unknown
Enthusiasm/commitment 5 4 3 2 1 Unknown
Communication skills 5 4 3 2 1 Unknown
TEACHING/INSTRUCTIONAL QUALITIES
Instructional strategies 5 4 3 2 1 Unknown
Classroom management and organization 5 4 3 2 1 Unknown
Presentation of subject matter 5 4 3 2 1 Unknown
Learning environment 5 4 3 2 1 Unknown
Professional growth and responsibilities 5 4 3 2 1 Unknown
Effective human relations skills 5 4 3 2 1 Unknown
Peers 5 4 3 2 1 Unknown
Parents 5 4 3 2 1 Unknown
Students 5 4 3 2 1 Unknown
Probable success as a teacher 5 4 3 2 1 Unknown

How long have you known the applicant?    _______________________________________________

Would you hire/rehire the above applicant?    __    Yes        __    No
Information given above is based on (check items which apply):

____ Applicant's principal
____ Student teacher under my supervision
____ Applicant's assistant principal 
____ Student in my class

____ Worked under my supervision
____ Personal acquaintance with the applicant
____ Co-worker
____ Other_________________________________

ADDITIONAL REMARKS:____________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________


Signature__________________________________

Position: __________________________________
Address:__________________________________ City:__________________________________
Date: ____________________________________  
EEOC