""P^S* -

Reference Questions (cont'd.)Have you had the chance to watch the candidate interact with children? D Yes D NoIf Yes, were the interactions positive? D Yes D NoWhy or why not?

Do you believe the candidate would be suitable to work at a school, in direct contact with children?n Yes D NoWhy or why not?

Would you have any reservations about the candidate In such a position? D Yes D NoIf 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 5 - Excellent N/A - Not applicable

Task I 2 3 4 5 N/A 1Accepted and grew from professional criticism D D a n D D

Acted as an effective role model D n D n D D

Communicated verbally n n D n DD

Exhibited high expectations for self and others D n n n D D

Maintained accurate records D n D n DD

Solved problems D D Dn D D

Worked with other staff n n D D nn

Worked with supervisors n n n nD D

Communicated with parents D n n nD D

Controlled and maintained discipline in a classroom D D n n DD

Got involved in extra-curricular activities D D D n Dn

Used multiple teaching strategies n n n DD D

Worked with children D D n nD D

Overall rating of the candidate n n nn D n 1

If you could rehire this person, would you do so? D Yes D With Reservation D NoIf No or With Reservation, please explain:

Are you currently using a staffing company?1 n Yes D No

May we contact you with information about Kelly Educational Staffing? 1D Yes D No 1Thank you very much for your time. You've been very helpful.Kelly Use OnlyFirst Attempt Date

Second Attempt Date

Conducted By

Conducted By

Result

Result

Documented in KSND Yes n NoDocumented in KSND Yes n No

Note: Reference checks are not required on transitioning substitute teachers when the school district provides a list of approvedsubstitutes. However, two reference checks are required for transitioning substitutes when they 1) are not on the approved list, 2) did nottransition on time or 3) left KES and then returned.

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Kelly Educational staffing*

EMPLOYMENT OR PROFESSIONAL REFERENCE VERIFICATIONTo:Name:

Title:

Employer:Fax No.:

Telephone No.:E-Mail Address:

From:

Kelly Representative:Fax No.;

Telephone No.:E-Mail Address:

Date:

No. Pages:

The candidate named below applied for a position with Kelly Educational Staffing and provided your name as a reference.We appreciate your assistance with verifying the information provided and assessing their qualifications. Please completethis request as soon as possible and return it to the Kelly representative listed above. Thank you.Candidate InformationCandidate Name: Employment Dates: / /Position/Job Title: Salary/Pay Rate: $ PerJob 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:$ perAre the Job Responsibilities correct? n Yes n No If no, correct Job Responsibilities:

Reference QuestionsHow are you acquainted with the candidate?n Supervisory role (Verify dates of candidate's previous employment.)n Coworkern Other (e.g., minister, doctor, teacher, lawyer)Note: Friends are not acceptable references. The candidate must have worked with the reference or must know the reference on aprofessional basis.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 NoIf Yes, please explain:

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