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Perscn calleo:
Telcphone numbe

tr..' name , L ,"-bt*!-and I work ut V u. F,-*n F''1'lilourolike ro ask l/ou jcme quesrions rbour.q,pp+if,zmTgeaie, who has appl t
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;rtrt*r L rhis a good time to speak with you?

Shat was your relationship to the appiicant?

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\I4:at rvere his,/her strong points?
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Vihat were irisAer weak points?

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ilc'.iz well did heishe work with srudents or collcagues?

A:e you awarc ofany allegations, complaints or concerns about the applicant's perfonnance or
cr:nduct including allegations ofinappropriate behavior with children or any allegations
c(r:ltained in sealed records,
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Il'yes to the above question, please provide detail.

If youwerepcr': ;r,a!lyresponsiblq,wouiJJ'ourehirethisapplicar,lt 1.8.f


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;, ;rr to the above questioir, list reasor,/s why you u,o, l i not rehire this applic,r '.

Is there anytirirr;, else you would likc to :,':rrc?


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}i1ynarlci'!::!::-|:^,-!-anrlIwork^,Uo_fu::.El,.\*KtaIiketoaskyou.sonrequestionsuoo,.,ffi*ohasapplit
tbr Q 1w*iposition. Is this a good time to speak with you?
\):lhat was your relationship to the applicant?

\r.:iat were his/her weak poir,ts?

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Hciv well did he/she work with students or colleagues'l

Ar': you arvare ofany allegatioos, complaints or concerDs aL<rut the applicant's perforinance or
conduct including allegaiions ofinappropriate behavior with chil&en or any allegations
cnntained in sealed records?
lf l,^
,y

If you v.,r;rc personally rcsponsibl:, r',,r;uld you rehire tlris apj,li.-).i1rt? Y Cg

,f no to the above qui.'stion, list reason/s why;',ri' worrld not rehire this a1,;rlicart.

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Is theri: ::,rything else yr;u would iii:.-, i,-r share?

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fttr Fa Is tbis a good time to speak wilh you?

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li,rw well did he/she work rvith students or colleagues?

-__ut..y $,4__tA-__a*^+._
Are you aware ofany allegatioas, complaints or concerrs about the applicant's performance or
co:rduct iucluding allegations ofinappropriate bchavior rvith chil&en or any allegations
contained in set'lcrl records?
fTV

Ilires to the above qucstion, pleasc provide detail.

Ii .y,.,u rvere personally respr:r,silJ9, would you rehire ii,, r applicant?


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Ifno to the al.r,,'c question, list reason/: ; hy you would uot rehiri. r;ris applicant.

I:r , lere anythiug else you i', ould like to sbarc?

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i'}age I of I

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