""P^S* -

Reference Questions (cont'd.)

Have you had the chance to watch the candidate interact with children?
If Yes, were the interactions positive?

D Yes

D Yes

D No

D No

Why or why not?

Do you believe the candidate would be suitable to work at a school, in direct contact with children?
n Yes

D No

Why or why not?

Would you have any reservations about the candidate In such a position?

D Yes

D No

If Yes, please explain:

What other comments would you like to add regarding the candidate?

Performance Assessment (On a scale of l to 5, please rate the following aspects of the candidate's performance.) ' ,,
1 - Poor

2 - Below Average

3 - Average

4 - Above Average
I

Task

5 - Excellent

N/A - Not applicable

N/A

Accepted and grew from professional criticism

Acted as an effective role model

Communicated verbally

Exhibited high expectations for self and others

Maintained accurate records

Communicated with parents

Controlled and maintained discipline in a classroom

Got involved in extra-curricular activities

Solved problems
Worked with other staff

Worked with supervisors

Used multiple teaching strategies

Worked with children

Overall rating of the candidate

If you could rehire this person, would you do so? D Yes

D With Reservation

D No

If No or With Reservation, please explain:

May we contact you with information about Kelly Educational Staffing?

Are you currently using a staffing company?

1 n Yes

D Yes D No

D No

Thank you very much for your time. You've been very helpful.
Kelly Use Only
First Attempt Date

Second Attempt Date

Conducted By
Conducted By

Result

Result

Documented in KSN

D Yes

n No

Documented in KSN

D Yes

n No

Note: Reference checks are not required on transitioning substitute teachers when the school district provides a list of approved

substitutes. However, two reference checks are required for transitioning substitutes when they 1) are not on the approved list, 2) did not

transition on time or 3) left KES and then returned.

e244

2008 Kelly Services, Inc.

R8/08

Kelly Educational staffing*

EMPLOYMENT OR PROFESSIONAL REFERENCE VERIFICATION

To:

From:

Name:

Kelly Representative:

Title:

Fax No.;

Employer:

Telephone No.:

Fax No.:

E-Mail Address:

Telephone No.:

Date:

E-Mail Address:

No. Pages:

The candidate named below applied for a position with Kelly Educational Staffing and provided your name as a reference.
We appreciate
information
provided and listed
assessing
Please complete
this
request asyour
soonassistance
as possiblewithandverifying
return ittheto the
Kelly representative
above.theirThankqualifications.
you.
Candidate Information
Candidate Name:

Employment Dates:

Position/Job Title:

Salary/Pay Rate: $

/
Per

Job Responsibilities:

Reference Information (Please enter the following information for the person completing this verification.)
Name:

Title:

Telephone No.;

How are you acquainted with the candidate named above? D Supervisory role

D Co-worker

D Other:

Employment References ONLY: Verification of Work Experience

(Please verify the following Information from the Candidate Information section above. Do not complete this for Professional References.)

Are the Employment Dates correct?

n Yes

D No

If no, con-ect Employment Dates:

Is the Position/Job Title correct?

n Yes

D No

If no, correct Position/Job Title:

Is the Salary/Pay Rate correct?

n Yes

D No

If no, correct Salary/Pay Rate:$

Are the Job Responsibilities correct?

n Yes

n No

If no, correct Job Responsibilities:

per

Reference Questions
How are you acquainted with the candidate?

n Supervisory role (Verify dates of candidate's previous employment.)

n Coworker

n Other (e.g., minister, doctor, teacher, lawyer)

Note:
Friendsbasis.
are not acceptable references. The candidate must have worked with the reference or must know the reference on a
professional
When did you work with the candidate?

What were the candidate's main job duties and responsibilities?

Why did the candidate leave your organization?

Were there any attendance problems?

Q Yes

D No

If Yes, please explain:

2008 Kelly Services, Inc.

e244

R8/08