Thanks to visit codestin.com
Credit goes to www.scribd.com

Scribd
Upload
5 views2 pages

References

The document is a request form for information regarding an applicant's evaluation for a position in the Henrico County Public School System. It includes a checklist for evaluating various attributes such as attendance, attitude, and communication skills. The form also requests confirmation of the applicant's contract status and reemployment potential.

Uploaded by

John Steinwinder
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
5 views2 pages

References

The document is a request form for information regarding an applicant's evaluation for a position in the Henrico County Public School System. It includes a checklist for evaluating various attributes such as attendance, attitude, and communication skills. The form also requests confirmation of the applicant's contract status and reemployment potential.

Uploaded by

John Steinwinder
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

CLEAR

P. O. Box 23120
3820 Nine Mile Road
Henrico, Virginia 23223-0420
(804) 652-3600

I have applied for a position in the Henrico County Public School System and would appreciate any information you
may offer in regard to the items below. Please complete this form and return to the Department of Human
Resources at the above address. I understand that this information will not be provided to me. Thank you for your
response to this request.

Devin M Bruetsch _______ __________


01/19/24
Name of Applicant (First, Middle Initial, Last) Date

_____________________ ___ Assistant


Administrative
Signature of Applicant Position Applied for

All applicants may be evaluated on the checklist below. Page two of this document may be used for those applicants who have not
taught and as an elaboration of the checklist. Clerical and paraprofessional personnel may also be evaluated on page two. Thank you
for your cooperation.

Please check ( √) each of the items below.

Superior Above Satisfactory Less than


Average Satisfactory Unknown
Attendance
Attitude/Enthusiasm
Judgment
Punctuality
Character
Knowledge of Work
Quality of Work
Communication Skills
Response to Supervision
Human Relation Skills

IF APPLICABLE:

Classroom Management
Instructional Effectiveness
Model for Students
Evaluation of Student Progress
Rapport with Students
Preparation and Organization of Learning Activities
Parent/Community Relations

Is person under contract? yes □ no □ Would you reemploy? yes □ no □


Indicate exact Grades or subjects taught _______
dates of service
Print Name
Signed Title
Organization Date
Address Phone
P. O. Box 23120
3820 Nine Mile Road
Henrico, Virginia 23223-0420
(804) 652-3600

NAME POSITION DATE

Signature

Title Date

You might also like