Reference Check Form
To be completed by applicant:
Instructions:
Please select two individuals (supervisors or equal) who are familiar with your job qualifications and that you have known for at least one year.
Applicant Name:________________________________________________________
Reference Name:________________________________________________________
To be completed by the reference:
Instructions:
Please complete the following information and give back to the applicant in a sealed envelope on company letter head. Please be sure to include your signature and date at the end of this reference check form.
Thank you.
What is your working relationship with the applicant? Did he/she work directly for you?
How long have you know the applicant?
Please list the applicant’s job responsibilities and if there were any job changes and/or promotions.
How would you rate the applicant’s ability to work effectively on a team?
How did the applicant compare to others in the same job?
What would say are the applicant’s greatest strengths? Limitations?
How would you rank the individuals character? (honesty, integrity, work ethic, attitude)?
How is the applicant’s attendance?
How would you explain the applicant’s ability to be flexible and accept changes?
How would you rate the applicant’s ability to interact positively with youth? Please be specific.
Please list any additional significant information regarding the applicant in order to determine suitability for employment:
To be completed by reference:
_________________________________________________
Print Name
_____________________________________________________
Signature
____________________________________
Contact Number
____________________________________
Date