Substitute Custodian

Substitute Reference FormThe applicant listed below has applied for a position as a substitute in Chesterfield County School District. As a part of our employee selection process, we request each applicant to forward a copy of this reference form to three persons who are familiar with his/her ability, potential and/or past performance. Your prompt attention in completing the items below and returning the form to us will be greatly appreciated. Your reply will be strictly confidential.Applicant's Name ____________________________________________ Date _____________________ Superior Above Average Below Unsatis- Average factory Physical Health Emotional Maturity Appearance Friendliness Flexibility Dependability Reactions to Suggestions Relations to Others Judgment In what relationship did you have the opportunity to form a judgment of this applicant?Dates of employment if employed by you: From_______________________ To _______________________ What was his/her job?________________________________________________________________________________________ This person's most valuable qualification is:_____________________________________________________ This person's greatest weakness is: ___________________________________________________________ Is this someone you would like to have working with your child: Yes__________ No__________ Would you prefer to talk with us by phone concerning this applicant? Yes__________ No__________ Signature ____________________________________________ Title __________________________________ Address ____________________________________________ Phone ________________________ ____________________________________________ Please return this form to: Chesterfield County School District ATTN: Rhonda Jordan 401 West Boulevard Chesterfield, South Carolina 29709 (Use reverse side for comments on any unusual or for additional information you wish to share with us.)