THJSL Referee Evaluation

Tualatin Hills Junior Soccer League
For use by Mentors ONLY
Referee Feedback Form

Thanks for taking the time to accurately and carefully provide the information regarding your game.
This information will remain confidential and will be used by THJSL to
improve the quality of the officiating services we provide.

Game Information: (Entries in yellow are required for the form to be submitted)

Game Location (Field): Date: Time: AM PM

Home Team: Away Team

Level (Age): Gender:

	Cautions (Yellow Cards)	Send-offs/Dismissals (Red Cards)
Home Team
Away Team

Submitter's Information:

First Name: Last Name: Role: Affiliated with the

Home phone # Work phone # Cell phone #

Your Email address:

SUMMARY - Overall Rating of the Center/Solo Official
If you don't want to fill out the remainder of this form,
please at least give us your rating of the Center
from 1 (worst) to 4 (best)

1 2 3 4

1 = Needs quite a bit of help
4 = Need to consider doing higher-level games

The Official's Conduct of the Match (Optional: to Support your Rating of 1 - 4, above)

Referee	The Center Referee accomplished the following:
Yes No Time:	Started the game at the schedule kickoff time (If not, please enter the approximate number of minutes it was late)
Yes No	Demonstrated a positive attitude; that is, s/he gave you the impression that s/he was really glad to be there helping with your game
Yes No	Introduced himself/herself to the coaching staff prior to the game
For the categories below, 4 is the best, 1 is the worst
1 2 3 4	Was fit and able to stay up with play 1= Essentially walked the entire game 4= Was (amazingly?) in position for almost every important play
1 2 3 4	Used the whistle effectively; that is, it was loud enough and used as needed
1 2 3 4	Verbally communicated with coaches and players as necessary
1 2 3 4	Controlled substitutions properly
1 2 3 4	Stopped play for injuries as needed
1 2 3 4	Conducted the game in a safe manner