UNIFIED SCHOOL DISTRICT 407
802 N. MAIN
PH: (785) 483-2173
RUSSELL, KS 67665
FAX: 785- 483-2175
An Equal Opportunity and Affirmative Action Employer
We would like to have your confidential evaluation on the qualifications of
who has applied for a certified position in USD 407 Russell County Schools.
Please select the appropriate administrator to submit this form to
-
Kent Michel - Simpson/Bickerdyke Elementary Principal
Gaylon Walter - Ruppenthal Middle School Principal
Larry Bernard - Russell High School Principal
David Couch - Superintendent of Schools
Kathy Cook - Special Education Director
Cory Funk
Please leave items blank if you do not feel qualified to answer them.
N/A = 1
Below Avg = 2
Avg = 3
Above Avg = 4
Superior = 5
Professional Purpose
:
1
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4
5
1.
Positive self-image
2.
Demonstrated investment in student growth
3.
Commitment to professional development
4.
Organizational commitment
Relationship Skills: Develops successful relationships with:
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5
1.
Students
2.
Parents
3.
Colleagues
4.
Administrators
Interpersonal Skills:
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5
1.
Communicative
2.
Personable
3.
Compassionate
Teaching/Learning/Organization Skills:
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5
1.
Lesson Design
2.
Daily Preparation
3.
Lesson Presentation
4.
Generator of alternative teaching strategies
5.
Classroom Management
6.
Attention to records & reports
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5
Overall Rating
General Questions
1.
Have you seen the candidate perform in a school setting?
Yes
No
2.
For how long and in what situation have you known the candidate?
3.
Responsive to supervision?
Yes
No
4.
If applicable, could the candidate remian in the present position?
Yes
No
5.
If this person were applying to you for a similar position, would you employ them?
Yes
No
6.
Are there any factors which might render the candidate undesirable as a teacher? If so, explain.
Yes
No
7.
What position do you believe the candidate is qualified to fill?
8.
Comments:
Signature:
Date:
02/22/2012
Position:
Email:
Phone: