DarlingtonCountySchool District

ADMINISTRATIVE REFERENCE FORM

Applicant InformationReference Information

Applicant Name: Reference Name:

(Street, P.O. Box, Apartment No., etc.)(Street, P.O. Box, Apartment No., etc.)

(City, State, Zip Code)(City, State, Zip Code)

Telephone: ( )Telephone: ( )

I, the undersigned, waive the right to review this reference form.

Applicant’s Signature______Date

Please rate the applicant on the following skills, abilities and knowledge using the following scale: HIGH LOW (Check one) 5 4 3 2 1

Willingly claims the role of leader and serves as an example to others|||||

Possesses inner drive which continuously propels him/her to make things happen and get things done|||||

Has the courage to ask for action and is persuasive enough to solve problems in a positive manner|||||

Takes charge of critical situations and makes firm, quick decisions|||||

Accepts personal responsibility for consequences of his/her actions|||||

Takes responsibility for performance of those persons he/she supervises|||||

Committed to the encouragement and development of students and teachers so that they can be successful|||||

Arranges people with an environment so that they can be successful|||||

Understands and works successfully with a wide range of people from diverse backgrounds to achieve||||| “win-win” outcomes

Shows caring and concern for co-workers and is readily available for consultation|||||

Organizes well and motivates people to accomplish goals while creating a sense of order and direction|||||

Identifies actions necessary to complete tasks and obtain results|||||

Knows how to manage, set performance objectives and measure progress|||||

Analyzes all aspects of a situation to gain thorough insight to make decisions in a timely manner|||||

Prioritizes and completes overlapping tasks in order to deliver desired outcomes within allotted timeframes|||||

Demonstrates ability to make unpopular and difficult decisions to achieve results|||||

Follows through on commitments and decisions to achieve results|||||

Builds trust with others and is able to cooperate with other team members to meet objectives|||||

Able to create positivity, excitement, and good feelings in the organization|||||

  1. How long and in what capacity have you known this applicant?
  1. What is this applicant’s greatest strength?
  1. In what area(s) would the applicant need support, remediation, training, etc? (Please support your opinion):

(Please complete reverse side)

Please check the statement which best describes your opinion about this applicant for an administrative/instructional support position.

□ This applicant is a proven leader in every sense of the word. He/she has initiated or accepted leadership roles and has been successful. I would rate him/her in the top 10% of administrative applicants.

□ This applicant has great potential to be a leader. He/she has the training and experiences to make this a reality.

□ This applicant has taken coursework in administration, but I have not observed him/her in any significant leadership role. I would suggest additional leadership opportunities.

□ This applicant has had some leadership opportunities. I would suggest that he/she might need to improve in the area(s) noted in # 3 above.

□ I am aware of past leadership experiences of this applicant and have reservations about him/her pursuing other leadership positions.

□ No comment.

□ Other:

May DarlingtonCountySchool District contact you should we have any further questions?

□ Yes □ No

Signature of Reference Current Title Date

Return to:DCSD

Department of Human Resources

120 East Smith Avenue

Darlington, SC29532

(May 2008)

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