ACET Professional Reference Form
1
Montgomery College
and
Montgomery County Public Schools
ALTERNATIVE CERTIFICATION FOR EFFECTIVE TEACHERS
PROFESSIONAL REFERENCE
Applicant Name
First Name
Last Name
MI
Reference Information
First Name
Last Name
Title
Email
Phone
Company Name
Street Address
City
State
Zip Code
Type Of Position Held By Applicant
Applicant’s Dates Of Service
From:
/
To:
/
Length /
Mo. Yr.
Mo. Yr.
Mos. Yrs.
If a former employee, state the reason for leaving:
Personal Qualities
This applicant is applying for a teacher education program to prepare to be a secondary school teacher. Please rate this
person on the following disposition areas: 1- Excellent 2- Acceptable 3- Not acceptable 4- Do not know
Ability to
communicate
Alertness
Maturity
Professional attitude
Honesty in relationships
Appearance
Initiative
Perceptiveness
Sensitive to the
feeling of others
Flexibility
Would you re-employ this person? Yes No If “No,” why not? Answer using the space below.
Form continues on Page 2
ACET Professional Reference Form
2
Please return the completed Professional Reference Form to:
ACET Program
Attn: Debra Poese, School of Education
Montgomery College
51 Mannakee Street, CS 118
Rockville, Maryland 20850
Additional Comments
Please provide detailed information on this candidate’s work with adolescents and in teaching roles if possible. Alternatively, describe
their general characteristics as would apply to a teaching role.
This information is confidential, will become the property of the ACET Program upon receipt, and will not be divulged to the applicant.
Date Signed