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SSBC Referee Evaluation Form
This form should be used as an evaluation form for Referees.
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* Indicates required question
Email
*
Your email
Basic Information
Assessor Name
*
Your answer
Assessor Level
*
1
2
3
Referee Name
*
Your answer
Referee Level
*
1
2
3
Date of Event
*
MM
/
DD
/
YYYY
Name of Event
*
Your answer
Location of Event
*
Your answer
Intellectual Vitality
Attitude towards learning
*
Your answer
Impact and influence
*
Your answer
Listening and understanding
*
Your answer
Ratings
Ratings of knowledge and understanding out of 5
*
1
2
3
4
5
Knowledge of Rules
Communication
Positioning
Attentiveness
Attitude/Poise
Reliability
Penalties
Meet Preparation Pre/During/Post
1
2
3
4
5
Knowledge of Rules
Communication
Positioning
Attentiveness
Attitude/Poise
Reliability
Penalties
Meet Preparation Pre/During/Post
Penalties: Number per distance M/F
*
Your answer
Overall Successes
*
Your answer
Overall Challenges
*
Your answer
Summary
Taking into account all factors, what is your overall assessment of the Referee’s performance?
*
1
2
3
4
5
Feedback Discussed with Mentee
*
Yes
No
Recommendation for Upgrade
*
Yes
No
Rationale for Recommendation
*
Your answer
Additional Comments
*
Your answer
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