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ITC Referee Form

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ITC REFEREE FORM

APPLICANTS NAME:
The above named person has applied to participate in the ECIS International Teacher Certificate
(ITC).Your name has been given as a referee. In order to assist ECIS in the selection process, we
would very much appreciate your assessment of the teacher's competencies and skills as listed
below.
The ECIS International Teacher Certificate (ITC) has been developed to offer a high-level continuing
professional development (CPD) opportunity for accomplished teachers. Participants will bring to
the program excellent teaching and interpersonal skills. The purpose of the ITC is to help teachers
to enhance and demonstrate their effectiveness as a first class international teacher.
Applicants for the ITC will be accomplished teachers who have already demonstrated their
commitment to CPD and who now wish to develop further their skills as teachers in an international
context. It is an exemplary qualification for exemplary teachers.
Successful teachers who are awarded the ITC will be expected to act as mentors/coaches to future
participants.
Please complete this online form which will be kept on record with the applicant's details. An
electronic copy of your submitted form will be emailed to you.
ECIS very much appreciates your assistance in this. Thank you.
REFEREE DETAILS
FIRST NAME:
LAST NAME
TITLE

SCHOOL/WORK EMAIL :
* This needs to be a verifiable email address from your school, and not a personal address, i.e. not
Yahoo!, Hotmail or Gmail
NATIONALITY:
CURRENT SCHOOL:
COUNTRY:

JOB TITLE
MAILING ADDRESS:
Please include international dialing code
PHONE NUMBER:
MOBILE/CELL NUMBER
HOW LONG HAVE YOU
KNOWN THE APPLICANT?
IS YOUR SCHOOL AN ECIS
MEMBER?

YES
NO

Please rate the above named applicant for each of the competencies listed below.
A) TEACHING COMPETENCIES
Uses effective teaching methods to achieve objectives:

Engages and challenges students by recognizing differences and aspirations:

Provides positive support for students with special learning needs including the highly able:

Understands the educational needs of a diverse student population:

Uses multi-media technology as a tool to enhance learning:

Knowledgeable within own curriculum area(s):

Knowledgeable about current curriculum and methodologies:

Demonstrates a range of teaching methodologies:

B) PLANNING, ASSESSMENT & EVALUATION

Prepares lessons with clear objectives to ensure successful learning by all students:

Uses assessment as part of teaching to diagnose students' needs:

Uses a range of assessment and reporting strategies:

Sets realistic and challenging targets for improvement and future planning:

Evaluates her/his own practice in relation to students' progress:

C) INTERPERSONAL & COMMUNICATION SKILLS


Strong interpersonal skills - relates well at all levels:

Excellent written and oral communication skills:

Deals appropriately with conflict:

Demonstrates energy and commitment:

Demonstrates a positive and optimistic attitude:

Evidence of flexibility and adaptability:

Ability to cope with change:

Team player:

Effective role model for students and other staff through personal and professional conduct:

This teacher is an internationally-minded educator:

I recommend this person for the ITC:


Yes
No
For applicants for the ITC/International Baccalaureate Certificate in Teaching and Learning:
This candidate is working in an authorised IB Programme:
Yes
No
Please complete all the relevant fields in this form before submitting.
If you have any problems, please contact helpdesk@ecis.org
Fields marked with an asterisk * are required fields.

UK Data Protection Act 1998


The ECIS will process the information collected in this form for the purpose of assessing teachers'
applications to participate in a program for the ECIS International Teacher Certificate. This
information will only be used by ECIS and its partner institutions in the program.
PLEASE SUBMIT TO itc@ecis.org

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