REFERENCE FORM – Substitutes

TO THE APPLICANT:

This reference form should be completed by an individual for whom you have worked or someone who can speak for the quality of your work. This person may include an advisor, a supervisor, a teacher, etc. Relatives cannotbe used as references. Provide the person an envelope labeled “Reference for Applicant’s Name”in which to seal the reference. Have the person return the envelope to: Human Resources Department, Lee County Schools, PO Box 1010, Sanford, NC 27331.

The Applicant should complete the top section of the form.

APPLICANT’S FULL NAME:

Last Name / First Name / Middle/Maiden Name

APPLICANT’S ADDRESS:

Street / City / State / Zip Code

APPLYING FOR A POSITION AS: _Substitute______

PERSON COMPLETING REFERENCE FORM

TO THE REFERENCING INDIVIDUAL:

Place this completed form in an envelope labeled “Reference for Applicant’s Name .” Sign your name across the sealed flap. Return the sealed envelope to: Human Resources Department, Lee County Schools,P O Box 1010, Sanford, NC 27331. Questions? Please call 919-774-6226.

Please respond to each of the areas below, giving your candid opinion of the applicant’s qualifications for the position indicated above. Narrative comments on page 2 of this form are welcome if you desire to elaborate. This information will be maintained in a separate pre-employment file and will not be made available to the employee except under subpoena or court order. Thank you for your assistance.

Complete this section for all substitute applicants:

Check the level at which the / Superior / Above / At / Below / Unsatisfactory
applicant consistently performs. / . / Expectations / Expectations / Expectations
5 / 4 / 3 / 2 / 1
Character (general conduct, ethics, morals)
Personal appearance (dress, grooming)
Energy level
Personality
Voice Quality
Tact
Self-control
Enthusiasm
Willingness to accept criticism
Ability to work without close supervision
Ability to work closely with others
Dependability
Promptness and thoroughness
Overall attitude
Loyalty and cooperation
Communication skills (oral)
Communication skills (written)
Decision-making skills
Scholarship
Narrative comments are welcome. Opportunities for observing the candidate: Yes _No_ (If yes, please explain.)
Do you know of anything that would cause the candidate to be unfit for this position? Yes No
(If yes, please explain.)
To your knowledge, has this applicant ever been subject to any disciplinary action or asked to resign?
Yes No(If yes, please explain.)
If you were personally responsible, would you recommend this applicant for employment?
Yes No (If no, please explain.)
Additional Comments:
Reference Identification
Signature
Printed Name
Position
Address
Telephone #
Date

Thank you for helping us to hire the best employees to serve Lee County students. Reference Page 2 of 2