Referee Report

(Expected completion time 3 minutes)

Name of Applicant: Referee Name:

Position Title: Organization:
Email Address: Contact Number: N/A
Were you his/her supervisor?
If so, for what period of time? ______________________
1. How would you describe the applicant’s skills/experience/competence (as appropriate) in the
workplace in relation to the question outlined below?
1.Poor 2. Satisfactory 3. Good 4. Excellent 5. Not able to comment
Decision Making
A. How would you assess the applicant’s ability to apply their knowledge and concepts in the
classroom?
1. 2. 3. 4. 5.

B. How would assess the applicant’s judgement, skills and ability to perform their duties?
1. 2. 3. 4. 5.
Organization and planning
C. How would you assess the applicant’s willingness to participate in quality improvement
activities that contribute to improving the educational program?
1. 2. 3. 4. 5.

D. How would you assess the applicant’s ability to manage their time and competing priorities?
1. 2. 3. 4. 5.

Collaboration
E. How would you assess the applicant’s ability to maintain positive relationships within the
workplace?
1. 2. 3. 4. 5.

F. How would you asses the applicant’s ability to prevent, negotiate conflict between peers and
other disciplines?
1. 2. 3. 4. 5.

Learning
G. How would you assess the applicant’s ability to accept feedback, learn from experience and
modify their behaviour appropriately?
 1. 2. 3. 4. 5.

H. How would you assess the applicant’s willingness to take advantage of learning opportunities
and their commitment to ongoing education and training?
1. 2. 3. 4. 5.

Professionalism
I. How would you assess the applicant’s ability to act appropriately and respectfully toward
colleagues and management?
1. 2. 3. 4. 5.

J. How would you assess the applicant’s punctuality and attendance in the workplace?
1. 2. 3. 4. 5.
Communication
K. How would you assess the applicant’s ability to build a report and convey relevant
information and explanations to parents?
1. 2. 3. 4. 5.

L. How would assess the applicant’s ability to convey clear and timely written and verbal
information to colleagues and maintain adequate record documentation?
1. 2. 3. 4. 5.

Comments:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

1. Would you re-employ the applicant? Why/why not?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

2. Are you aware of any professional conduct or past performance issues that may be relevant
and appropriate for us to consider.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
To avoid burdening you with further mail, I would like to thank you in advance for your
cooperation.

To avoid burdening you with mail, we would like to thank you in anticipation. For further

information please contact me on (Number) or email.