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Work Reference Sheet - (to be completed by work supervisor)
This page should be completed and submitted or mailed to Janice Yetter, Department of Special Education , 5451 Beaverkill Road, Columia, MD 21044, by March 1, 2018
Applicant:
School/Program:
Days Absent : Current Year
Days Absent: Previous Year
Days Tardy: Current Year
Days Tardy: Previous Year
Comments regarding attendance:
Comments regarding work performance:
Other comments:
By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.
Date
MM
/
DD
/
YYYY
Print Name:
Title and Phone Number:
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This form was created inside of Howard County Public School System. - Terms of Service - Additional Terms