Teacher Reference Check Template Page 2
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212.
What did the candidate do, if anything, that was unexpected or out of the ordinary?
13.
Are there any other references we could contact?
14.
Please rate the following on a 1‐5 scale (5 being high):
Low
High
Comments, if needed:
Flexibility in dealing with change
1
2
3
4
5
Ability to handle stress
1
2
3
4
5
Relationships with co‐workers
1
2
3
4
5
Relationship with supervisor
1
2
3
4
5
Overall quality of work
1
2
3
4
5
15.
Candidate’s Reason for Leaving: ___________________________________________________
16.
Has this person ever had any performance concerns for which corrective action was given, either verbally
or in writing? ____ NO ____ YES, Explain: ______________________________
______________________________________________________________________________
17.
Has this person ever been the subject of a substantiated report of child abuse or sexual conduct?
____NO
____YES Explain: __________________________________________________
18.
Would you rehire this person without reservation? ____ YES
____ NO ____ MAYBE
19.
What advice do you have for us in supporting this person to be successful?
20.
Is there anything you would like to add about the candidate?
Subject matter knowledge
__________________________________________________________________
Pedagogical knowledge ___________________________________________________________________
Track record of student achievement
___________________________________________________________________
Proficiency with instructional materials
___________________________________________________________________
Position: _____________________________________________________________________________
Completed By: _______________________________ Date: _______________________
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Parent category: Business