Reference Check Form

Instructor Reference Form

Please share your thoughts on the candidate’s professionalism and ability to teach students of all ages.

Applicant’s Name(Required)

First Last

What is your relationship to this candidate?

What position and responsibilities did this person hold?

How well would you say that this person responds to supervision?

How would you rate this person’s attendance?

Please describe this person’s dependability.

How would you rate this person’s willingness to assume responsibility?

Please describe this person’s ability to follow instructions.

Please describe this person’s quality of work.

What are this person’s strong points?

What are this person’s weak points?

If given the opportunity, would you reemploy this person?

If applicable

Would you like to add any additional comments?

Submitter’s Name(Required)

First Last

Submitter’s Email Address(Required)

Submitter’s Title/Position

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Name(Required)

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Email(Required)

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Instructor Reference Form

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