Innovation Montessori Reference Form Section 768.095, Florida Statutes, provides immunity from liability in releasing information about a former employee's job performance to a prospective employer. Applicant First Name: Applicant Last Name: Date: Position recommended for: Teacher - Certified Teaching Assistant Support Staff Administration Reference First Name: Reference Last Name: Position: Place of Employment: Telephone Number: Did this person work for you? Yes No If yes please provide the employee's start date: Date employment ended: In what capacity do you know this individual? Was this person recomended for continued employment? Yes No If no, please explain: How was this individual's job performance? Do you know of any reason this person should not work with students? Yes No If yes, please explain: Was this person ever disciplined? Yes No If yes, please explain: Was this person terminated? Yes No If yes, please explain: Was this person ever referred to a state licensing/certifying authority? Yes No If yes, please explain: If you had a position available would you re-hire this person? Yes No If no, please explain: Additional Comments: Send
