Application Evaluation Form

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					                                ESCAMBIA COUNTY SCHOOL SYSTEM
                                             Office of Human Resources
                                                    P.O. Box 307
                                              Brewton, AL 36427-0307
                                         APPLICANT EVALUATION FORM

                                                                  PART I
                                                     (To Be Completed by Applicant)
    Three References are required.
   Applicant Name                                                   Social Security Number
   Home Telephone                             Work Telephone                                 Position Desired

Please complete the evaluation found in Part II below based on your knowledge of my background and return in this self addressed
mailer. I hereby waive my right to access 0f this confidential recommendation obtained for my application for employment.

                        Signature                                                                            Date

                                                        Part II
                                              (To be Completed by Evaluator)

COMMAND OF ENGLISH                  Extremely                   Correct in usage         Usually correct            Frequently
LANGUAGE                             fluent/precise                                                                     incorrect
ATTENDANCE RECORD                   Outstanding                 Average, some            Fair, more than an         Poor attendance
                                     attendance record,           absences                  average number of           record
                                     very few absences                                      absences
WORK HABITS                         A self starter, highly      Motivated and            Fair amount of             Poor work habits
                                     motivated,                   enthusiastic about        enthusiasm and
                                     extremely                    job assignments           motivation
PROFESSIONAL                        Always professional         Professional             Usually                   Frequently
ATTITUDE                                                                                    professional               unprofessional
USE OF SOUND                        Exceptional in              Good in common           Fair in judgment         Unreliable in
JUDGEMENT                            judgment                     sense                                                judgment
RELIABILITY                         Always dependable           Usually                  Fairly reliable          Inconsistently
                                                                  dependable                                           reliable
CHARACTER                           Outstanding                 Above average            Average                  Fair
RELATIONSHIPS WITH                  Superior                    Above average            Satisfactorily           Frequently
OTHERS                                                                                                                 annoying
COOPERATION                         Outstanding                 Cooperative           Usually cooperative         Uncooperative

      Please comment on the following:
      Would you recommend applicant for the position applied?             Yes        No
          If no, Please explain.
      Would you reemploy?         Yes       No
          If no, please explain.
      General Comments
      Name (print/type)                                            Title
      Signature                                                    Date
      School District/Business Address                             Telephone

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