Page 18 - Teacher Selection and Onboarding Guide

THE SCHOOL DISTRICT OF PALM BEACH COUNTY/ DIVISION OF HUMAN RESOURCES Applicant ID #
3300 Forest Hill Blvd., A-132, West Palm Beach, FL 33406 Tel. 561-434-8430 Fax: 561-434-8561
Employment Reference

The applicant has applied for a position with the School District of Palm Beach County and has listed you as a reference. This reference form will be included in
the applicant’s file for review by the appropriate supervisor. Return the completed form to the applicant or fax or mail to the above number/address. Falsifying
this document will result in a ban from employment eligibility with the District for one year. Print and use blue or black ink.
SECTION I SECTION II
Applicant Name:
Evaluator Name

Evaluator Title
I authorize you to provide the Palm Beach County School
District with information regarding my suitability for Company/School
employment. *Note: all references will be verified by
Human Resources.
Address

Direct Phone #

Signature of Applicant E-mail
SECTION III: TO BE COMPLETED BY EVALUATOR
I have known the applicant (check one)
Current Employer Former Employer Co-worker Student Volunteer Professional Personally
PROFESSIONAL TRAITS Excellent Good Average Below Average Unacceptable Not Applicable
Dependability/Reliability
Attendance/Punctually
Ability to Work with Others
Ability to Accept Criticism
Judgment/Common Sense
Language and Communication Skills
Overall Job Performance
TEACHING TRAITS
Enthusiasm for Teaching
Knowledge of Subject Matter
Lesson Planning/Preparation
Sensitivity to Individual Student Needs
Student Response to Teaching
Ability to Work with Parents/Community
Classroom Management (Discipline)
Employment dates or length of time you have known the applicant: From / / To: / /

Would you consider hiring (rehiring) the applicant? Yes No Position/ job title when employed
Would you approve hiring (rehiring) the applicant as a substitute teacher? Yes No Not Applicable
Does company policy prohibit rehiring? Yes No
Were any disciplinary actions initiated with this applicant? Yes No If, yes, provide information below*

If former employee, why did the applicant leave your employ?
* Provide any additional information on the applicant we may need to know as a prospective employer.

OFFICE USE ONLY
/ /
Signature of Evaluator Date Date / / Time :
PBSD 0606 (Rev. 7/24/2013) Per Florida Statute 119, this form will be shown to applicant and other members of the public, only upon specific request.