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Ureau: Siudc?N

This document is a reference form for a teacher applicant to Broward County Public Schools in Florida. It requests information about the applicant from the evaluator, including their qualifications in areas like classroom management, planning and organization, judgment, and sensitivity to others. The evaluator is asked if they would employ or reemploy the applicant and any additional comments. Contact information for the evaluator is also requested so the reference can be verified.

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78 views1 page

Ureau: Siudc?N

This document is a reference form for a teacher applicant to Broward County Public Schools in Florida. It requests information about the applicant from the evaluator, including their qualifications in areas like classroom management, planning and organization, judgment, and sensitivity to others. The evaluator is asked if they would employ or reemploy the applicant and any additional comments. Contact information for the evaluator is also requested so the reference can be verified.

Uploaded by

api-483325082
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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The School Board of Broward County, Florida

Instructional Staffing Department


600 Southeast Third Avenue, Fort Lauderdale, Florida 33301
Phone (754) 321-2320 FAX (754) 321-2716
REFERENCE FORM
0 Teacher Application Reference @ Substitute Teacher Application

Section T: To be completed by the Applicant

\jY �\Tij'\Q\,:'\
\·J _.. ,...,_ ureau Social Security Number:
C... - .J (Last Four Digits Only)
Applicant's Name: v€{ 4 __
XXX-XX-_ 1 8 _
8
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has applied for an instructional position in the following area/s: ____________________

Section II: To be completed by the Evaluator


t<i 0
� t:i::I �
0
0
p.. ""..,
(t)
(t)
0
�
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C,
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I h£e known this applicant:
aq

� "'.,,.
(1) '1:l 00

"'.., 13" as a student O as an employee


M-
c- :;!
ti,'

0 personally O as a co-worker
CLASSROOM MANAGEMENT 8 0 0 0 0 0 Dates of employment or length of time you have known

ABIUTY TO PLAN AND ORGANIZE


e0 0 0 0 0 the applicant (mm/yr):
From_/ ___ to_/
p c�rr-
/J ,,._,....,.,... I

USES GOOD JUDGEMENT


8 0 0 0 0 0 Position or job title of the applicant when employed:

SENSITIVITY TO OTHERS
� 0 0 0 0 0 SiUdc?n�
SHOWS LEADERSHIP
0 0 0 0 0 Your title at the time you supervised the applicant:

SHOWS INITIATIVE
@ 0 0 0 0 0
(IT@'od((\:9 -frofessti r

DECISION MAKING SKILLS


0 0 0 0 0 0
Do you know of any reason why it would not be advisable
0 0 0 0 0 0 for this individual to be employed in a capacity wh�e/ she
""f'
TOLERANCE FOR STRESS
would come in contact with children? Yes O No
0 0 0 0 0 0
If yes, please explain: ____________
COMMUNICATION SKILLS

@ 0 0 0 0 0
ADAPT ABIUTY/COOPERATION
I would employ or reemploy this individual: � Yes O No
OVERALL JOB PERFORMANCE @ 0 0 0 0 0
Tea.rt\_
&'ye$ l OCY (.
ADDITIONAL COMMENTS:
Clhu\.

Please include a phone and fax num�']' where you can be reached to verify this reference.
PhoneFr\5\} 2_()� 250:a_ Fax:.,___,_________

School/Company Name: -='------------ Date:-=--------'----''----------­


t)-=a.-Q_,
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Address: -=-- c:::::....:._
O:._,,o='------"':,a�,,f--L.-'--'-'=-:_-�'---=-�-=-__)��=-+--=:.=....,,..--=..:____:,:,:____;..___:: ��..:;:f<
L...._L�·R__,
--=

This form will be shown to the applicant or other members of the public only upon specific request, in compliance with Florida Statute 119, Public
Records Laws. Form Revised 12/09

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