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Career Services
PO Box 641061 * Lighty Building 180 * Pullman, WA 99164-1061
509-335-2536 * 509-335-4015 (fax) * CareerServices@wsu.edu

This Form is Non-Confidential. The applicant noted on this form has given authorization to obtain information from listed references.

Writers of References - Please read this before filling out this form.

Your willingness to provide your honest opinion of the applicant identified on this form is greatly appreciated. The selection of personnel is a very important task in any organization, and the information provided by people who know applicants is valued highly.

Please rate this applicant in each category by comparing the individual with all others you have observed teaching. Be careful not to skew ratings in a positive direction. When this happens, applicants begin to look very similar and the reference material is not as beneficial in helping discern which applicants are stronger.

After completing both parts of this form, please insert it into an envelope, and return it to Career Services at the address above. Thank you.

Applicant's Information

I have known (applicant’s name) First MI Last

for the past (i.e. six months) .

I have formally observed her/him (i.e. student teaching)

during the school year(s).

At the time I observed the applicant, my role/title was

at (please give location)

I evaluated this applicant as their supervisor evaluator colleague other

for (please give a length of time)

Reference Writer's Information

Name
Address
City
State, Zip	,
Office Phone
Message Phone

REFERENCE WRITER PLEASE NOTE: Please rate this applicant on a scale of 1 to 7, with 1 being low and 7 being high, in each of the following factors. NA is not observed. Compare this individual to all others you have observed. You can check only one box per factor. You may receive a telephone call to confirm / verify your responses.

FACTORS	1	2	3	4	5	6	7	NA
Classroom Management. Effectively manages large and small groups, and individuals; creates an atmosphere conducive to learning by developing routines and procedures to increase learning.
Behavior Management/Discipline. Establishes and uses appropriate behavior management procedures; recognizes conditions which may lead to discipline problems; establishes clear parameters for student behavior; develops strategies to prevent discipline problems; responds appropriately when problems occur; assists students toward self-discipline.
Flexibility. Willing to learn new concepts and ways of doing things; cooperates with youth and adults; effectively uses various teaching styles; successfully teaches a variety of assignments; adapts to others in a team, staff, or parent situation.
Instructional Skills. Plans, implements, and evaluates instructional activities; has knowledge of, and applies current approaches to teaching, new ideas and skills; uses a variety of styles/methods which reflect planning and pacing skills appropriate to students; monitors results and takes appropriate action; assesses students' needs, prescribes programs, and provides strategies appropriate to age, background and intended learning of students.
Commitment to Accomplishment for Self and Others. Establishes high expectations for self and students; exerts effort to attain goals; organizes, predicts, and monitors ideas, time, materials, and space to cause achievement to take place.
Relation to Students. Develops favorable relationships with students; exhibits empathy and responds to student needs; listens, has patience, and demonstrates caring; accepts students as they are; is considered open and approachable by students; works collaboratively with students in decision-making.
Understands/Appreciates Multicultural and Diverse Populations. Relates positively to youth and adults of varying socioeconomic, cultural, racial/ethnic backgrounds, different learning styles, and various disabilities; adjusts classroom activities to reflect the diversity of students.
Scholarship and Conceptual Skills. Demonstrates ability to learn new ideas and skills for substantive and methodological aspects of teaching, for learning initial information necessary to function in the local setting, for applying new concepts during teaching, as the job changes, and in solving problems.
Enthusiasm. Exhibits appropriate overall optimism and zeal, using them to motivate student learning. Uses facial expressions, body language, and presentation skills that demonstrate a caring and warmth toward students and an enthusiasm for learning.
Professional Orientation/Collaboration. Possesses an awareness of current educational developments and their applications, including teaming, child development and approaches to teaching; demonstrates a willingness to work collaboratively at the building and district level, effectively building relationships and responding positively to constructive comments and supervision; holds a strong belief in the importance of education; sincerely interested in welfare of all students and in solving problems by consensus.
Technological Literacy. Makes appropriate uses of available technology in relation to planning activities, learning activities, and record keeping; integrates technology into the learning process.