Referee Evaluation Form

• Coach Name

  Coach Name * First Last
• Your Team Name *
• Time of Game

  Time of Game * : HH MM AM PM AM/PM
• Field Number *

• CENTER REFEREE

  Please evaluate the Center Referee

• Center Referee: *

  Center Referee:	Excellent	Above Average	Average	Below Average	Poor
  Appearance	Appearance Excellent	Appearance Above Average	Appearance Average	Appearance Below Average	Appearance Poor
  Fitness	Fitness Excellent	Fitness Above Average	Fitness Average	Fitness Below Average	Fitness Poor
  Attitude	Attitude Excellent	Attitude Above Average	Attitude Average	Attitude Below Average	Attitude Poor
  Decisions	Decisions Excellent	Decisions Above Average	Decisions Average	Decisions Below Average	Decisions Poor
  Knowledge	Knowledge Excellent	Knowledge Above Average	Knowledge Average	Knowledge Below Average	Knowledge Poor
  Game Control	Game Control Excellent	Game Control Above Average	Game Control Average	Game Control Below Average	Game Control Poor
  Offside Decisions	Offside Decisions Excellent	Offside Decisions Above Average	Offside Decisions Average	Offside Decisions Below Average	Offside Decisions Poor

• ASSISTANT REFEREE

  Please evaluate the Assistant Referee closest to you

• Assistant Referee (AR 1): *

  Assistant Referee (AR 1):	Excellent	Above Average	Average	Below Average	Poor
  Appearance	Appearance Excellent	Appearance Above Average	Appearance Average	Appearance Below Average	Appearance Poor
  Fitness	Fitness Excellent	Fitness Above Average	Fitness Average	Fitness Below Average	Fitness Poor
  Attitude	Attitude Excellent	Attitude Above Average	Attitude Average	Attitude Below Average	Attitude Poor
  Decisions	Decisions Excellent	Decisions Above Average	Decisions Average	Decisions Below Average	Decisions Poor
  Knowledge	Knowledge Excellent	Knowledge Above Average	Knowledge Average	Knowledge Below Average	Knowledge Poor
  Game Control	Game Control Excellent	Game Control Above Average	Game Control Average	Game Control Below Average	Game Control Poor
  Offside Decisions	Offside Decisions Excellent	Offside Decisions Above Average	Offside Decisions Average	Offside Decisions Below Average	Offside Decisions Poor

• ASSISTANT REFEREE

  Please evaluate the Assistant Referee on the opposite side of the field from you

• Assistant Referee (AR 2): *

  Assistant Referee (AR 2):	Excellent	Above Average	Average	Below Average	Poor
  Appearance	Appearance Excellent	Appearance Above Average	Appearance Average	Appearance Below Average	Appearance Poor
  Fitness	Fitness Excellent	Fitness Above Average	Fitness Average	Fitness Below Average	Fitness Poor
  Attitude	Attitude Excellent	Attitude Above Average	Attitude Average	Attitude Below Average	Attitude Poor
  Decisions	Decisions Excellent	Decisions Above Average	Decisions Average	Decisions Below Average	Decisions Poor
  Knowledge	Knowledge Excellent	Knowledge Above Average	Knowledge Average	Knowledge Below Average	Knowledge Poor
  Game Control	Game Control Excellent	Game Control Above Average	Game Control Average	Game Control Below Average	Game Control Poor
  Offside Decisions	Offside Decisions Excellent	Offside Decisions Above Average	Offside Decisions Average	Offside Decisions Below Average	Offside Decisions Poor

• Comments or Observations: *
• Are you a referee? *
  Are you a referee?

  No - Not a Referee Yes - USSF Referee
• Your Name

  Your Name * First Last
• Your Email *