AYSO Assessment Feedback Form National Referee Program Revision 8/08 It is requested that each referee who has received an assessment provide feedback on the quality of the assessment by completing this form. Please print your comments and forward the completed form to the AYSO National Support & Training Center, Attn Officiating Dept. 12501 S. Isis Ave, Hawthorne, CA 90250. Name of Assessor ___________________ Section ____ Area ____ Region ____ Date of Assessment _____________________ For what level were you being assessed? Advanced National Service (Circle One) Who assigned your assessor? _____________________________________________ Was the assessment a positive experience? Yes ____ No ____ Were the Assessor’s comments consistent with your training? Yes __ No __ Would you welcome another assessment by this assessor? Yes ____ No __ What could the assessor have done differently to improve the assessment process or assessment feedback:_____________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ ____________________________________________________________ Additional Comments:____________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ ______________________________________________________________ Optional Information (will be kept confidential) Referee’s Name _________________________________ Region No. ______ Address _____________________________________________________ ______________________________________________________ _ Telephone Number ______________ E-mai l____________________ National Referee Program Revision 8/08
AR 1 AR 2 R Trip R R R R R R R R R R R Hold Handling Push Trip R R R B1406 Blue B1421 Red #2 10 th #10 22 d #4 9th #25 35th 2-2 BA@it.com B. A Goodwin I. B. Ref 6/5/0X U14B 6 I. M. Two U. R. One Good Position General positioning Closer to play Little help OS Missed 10th Communications with AR’s Use of Whistle Off diagonal when needed Anticipating play R
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