Ovid-Elsie Area Schools
Employment Reference Form
(This Form Is Not Confidential)



To Be Completed By Hiring Administrator

Applicant Name:
SSN (Last 4 Digits): _________________________________________
Position Applied For:

Name of Person Providing Reference: _________________________________________
Title: _________________________________________
Company Name: _________________________________________
Type of Business: _________________________________________
Phone Number: _________________________________________

Relationship to the Applicant (Check One)
______ Current Employer
______ Former Employer
______ Supervising Teacher
______ College Professor
______ Personal

Please Complete the Requested Information Below

  1. Dates of employment or time you have known applicant
    (Month/Year) ______ / ______ to ______ / ______


  2. Applicants title or job position at time of employment

    ___________________________________________________________________


  3. Your title at the time you supervised this applicant.

    ___________________________________________________________________


  4. The applicant has applied for the position of:

    ___________________________________________________________________
    Is the applicant suited for the position: ______ Yes ______ No


  5. Do you know of any reason why it would not be advisable for this individual to be employed in a capacity where he/she would come in contact with children?
    ______ Yes ______ No
    If no please explain why:

    _____________________________________________________________________________________________________________

    _____________________________________________________________________________________________________________

    _____________________________________________________________________________________________________________


  6. If former employee, why did this applicant leave your employ?

    _____________________________________________________________________________________________________________


  7. Would you hire or rehire this applicant?

    ______ Yes ______ No


  8. Provide additional comments about this applicant:

    _____________________________________________________________________________________________________________

    _____________________________________________________________________________________________________________

    _____________________________________________________________________________________________________________

    _____________________________________________________________________________________________________________


Place an “X” in the approprate column.
  Excellent Good Fair Poor Not Observerd
PERSONAL TRAITS
Attendance / Punctuality          
Character          
Cooperative          
Dependable          
Dress Appropriately          
Iniative          
Reliability          
Self Control          
Sound Judgement          
Tact          
PROFESSIONAL TRAITS
Ability to work with Parents / Community          
Classroom Management Skills          
Communication Skills          
Enthusiasm for Teaching          
Instructional Technique / Methods          
Job Performance          
Knowledge of Subject Matter          
Lesson Planning and Preperation          
Sensitivity to Individual Student Needs          



Excellent Good Fair Poor
10 9 8 7 6 5 4 3 2 1



OEAS Hiring Administrator's Signature: _______________________________________



Print Name:
Position / Title:
Telephone:
Location:
Date: