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CHS REFERENCE FORM

You have been listed as a reference and we would appreciate your honest evaluation of this candidate and their ability to fill this position. Any information filled in this form will remain confidential. Thank you for your assistance.

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Please include candidate's name who referred you. *

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RELATIONSHIP TO THIS CANDIDATE

How long have you known this candidate and in what capacity?

What was the position(s) held by this person?

What was the reason for this candidate leaving?

Has this candidate demonstrated a real commitment to Christian living both in and outside of their job?

Please explain. *

Please list this candidate's greatest strengths.

Any concerns or areas to improve?

Is there any reason that this candidate should not work with minors? *

Please describe. *

Has anyone, to your knowledge, ever brought a civil or criminal charge against this candidate, an act of misconduct, or alleging physical/sexual abuse by this person? *

Please describe. *

Is there any reason we should not hire this individual? *

Please describe. *

POSITION CANDIDATE IS APPLYING FOR

Please select the type of position the candidate is applying for: *

Instructional Position (Teaching, Substitute or Daycare)
Non-Teaching Position (Staff Employee)

Not sure? Please check the email you received with the link to this reference form to see which position this candidate is applying for. (You may check both if applicable.)

TEACHING PERFORMANCE

Rate the candidate in the following areas:

How would you rate the candidate when it comes to honesty? Trustworthiness?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How does the candidate handle stressful or challenging situations?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate’s ability to remain adaptable?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's effectiveness of instructional lesson planning?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's effectiveness of lesson delivery?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's knowledge of subjects and content?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's student engagement in their learning?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's effectiveness at classroom management?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's relational connection with students?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's effectiveness relating to parent concerns?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's dependability, attendance and punctuality?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's performance as a team player and having a positive attitude among staff?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's ability to of using good judgement?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this candidate's ability to use current technology?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate’s overall job performance?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

Would you like to add any additional comments?

EMPLOYEE PERFORMANCE

Rate the applicant in the following areas:

What were the candidate’s daily duties and responsibilities?

How would you rate the candidate performing those daily duties and responsibilities?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate’s listening skills?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

Tell me about the candidate’s ability to communicate across teams.

What are the candidate’s greatest strengths they bring to your team/company?

What are the candidate’s primary areas or opportunities for growth?

How does the candidate manage their time?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate’s ability to prioritize tasks.

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate when it comes to honesty? Trustworthiness?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How does the candidate handle stressful or challenging situations?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate’s ability to remain adaptable?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this applicant's dependability, attendance and punctuality?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this applicant's organizational and planning skills?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this applicant's showing initiative outside of the workplace?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this applicant's performance as a team player and having a positive attitude among staff?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this applicant's ability to of using good judgement?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate this applicant's ability to use current technology?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

How would you rate the candidate’s overall job performance?

Outstanding	Competent	Needs Improvement	Poor Performance	Not Observed
OutstandingItem #3 Outstanding	CompetentItem #3 Competent	Needs ImprovementItem #3 Needs Improvement	Poor PerformanceItem #3 Poor Performance	Not ObservedItem #3 Not Observed

Would you like to add any additional comments?

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REFERENCE CONTACT INFORMATION

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