SSBC Referee Evaluation Form
This form should be used as an evaluation form for Referees.
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Email *
Basic Information
Assessor Name *
Assessor Level *
Referee Name *
Referee Level *
Date of Event *
MM
/
DD
/
YYYY
Name of Event *
Location of Event *
Intellectual Vitality
Attitude towards learning *
Impact and influence *
Listening and understanding *
Ratings
Ratings of knowledge and understanding out of 5
 *
Minimum
Low
Moderate
High
Excellent
Knowledge of Rules
Communication
Positioning
Attentiveness
Attitude/Poise
Reliability
Penalties
Meet Preparation Pre/During/Post
Penalties: Number per distance M/F *
Overall Successes *
Overall Challenges *
Summary
Taking into account all factors, what is your overall assessment of the Referee’s performance?
*
Poor
Excellent
Feedback Discussed with Mentee *
Recommendation for Upgrade *
Rationale for Recommendation *
Additional Comments *
Submit
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