Mentor Feedback Form
Referee			Grade		E-mail
Date		Time		Teams
Mentor					Mentor Signature
Arrived on time (30 min before game)					Yes	No
Uniform			Acceptable		Needs Work
Pre-game instructions			Gave Basic Info		Yes  No		Spoke Clearly  Yes  No
Hand signals -		mechanically correct			Most  Some  Few
		correct direction			Most  Some  Few
		decisive			Most  Some  Few
		held 2 sec.			Most  Some  Few
		recognized IFK(arm raised)			Most  Some  Few
Whistle -	volume	Good	Needs work
	length	Good	Needs work
Voice -	coached the laws when appropriate				Yes	No
	spoke to players when appropriate				Yes	No
Fouls -	recognized				Most  Some  Few
	penalized correctly				Most  Some  Few
	correct restart				Most  Some  Few
Eye contact -		Subs	Most  Some  Few		Advantage -
		Offside	Most  Some  Few		Recognized			Yes No Needs Work
		Throw-in	Most  Some  Few		Voice/Arm signal given			Yes No Needs Work
		Foul	Most  Some  Few		Called back if appropriate			Yes No Needs Work
Positioning -
Used diagonal system of control				Yes No Needs Work		Free kick   Yes  No  Needs Work
Kept within 10 - 20 yd				Yes No Needs Work		Throw-in    Yes  No  Needs Work
Corner kick				Yes No Needs Work		Stoppages Yes  No  Needs Work
Goal kick				Yes No Needs Work		Anticipates play  Yes  No  Needs Work
Transitions quickly to active play				Yes No Needs Work
Fitness -	maintained pace throughout				Yes  No  Needs Work
	Used 3 speeds as appropriate				Yes  No  Needs Work
Showed confidence			Yes  No		Maintained focus throughout				Yes  No
Admin -	checked field			Yes	No
	collected fees			Yes	No
	obtained roster			Yes	No
Strong points
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Recommendations for improvement
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