‫جمهوری اسالمی افغانستان‬ ‫د افغانستان اسالمی جمهوريت‬

‫ادارۀ مستقل ارگانهای محلی‬ ‫د سيمه یيزو ارگانونو خپلواكه اداره‬

‫معینیت پالیسی وانسجام"‬ ‫د پالیسی اوانسجام" معینیت‬

‫‪Islamic Republic of Afghanistan‬‬

‫‪Independent Directorate of Local Governance‬‬
‫‪Deputy Minister, Policy and Coordination‬‬
‫ریاست امور شاروالیها‬

‫‪REFERENCE CHECK FORM‬‬

Candidate: ………………………………………….. Relationship to the
Candidate:
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Position Considered for: …………………………... Phone:

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Check made by: ……………………………………. Name:
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Date: ………………………………………………... Position:

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Information obtained from: Company/Organization:

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Relationship to candidate:
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1- Employment dates – From: ……………………..To:

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2- Tittle:
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3- Income when he/she left: Salary $....................................................Hourly/Monthly

4- Please describe his/her job briefly:

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5- Position (s) suppervised:
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6- Describe his strenghts:

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7- Describe the areas oh his improvement:

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8- On the last performance evaluation, can you comment on what was particularly
noted? Please elaborate:
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9- How would describe his/her interpersonal relationships/working with others?

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10- Reasons for leaving: ………………………………………………………………..

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11- Would you re-employ him/her if you had a suitable opening?..................................

12- Overall quality of work performance: ……………………………………………...
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13- Please advise any performance issues: ……………………………………………..

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14- Ability to complete tasks in the expected time farme: ……………………………..

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15- General evaluation/comments: ……………………………………………………..

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Signature: ………………..
Date: ……………………..