Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO OCCIDENTAL

BACKGROUND INVESTIGATION FORM

Applicant Subject for Background Investigation

Level:______________________
Name : _________________________
Gender : _________________________
Position applying for: _________________

Respondent:
Name : _____________________ Position :
____________________
Company/Organization: _______________
Years/months working with the applicant : ___________________

Work Relationship to the applicant (Please check the appropriate box)

Supervisor of the Applicant

Peer/ Co-employee of the applicant
Subordinate of the applicant
No work relationship but belong to
same organization/association

Scaling:
5 - Demonstrated positive attitude
4 - Demonstrated positive attitude most of the time
3 - Demonstrated positive attitude sometimes
2 - Demonstrated with positive attitude rarely
1 - Demonstrated with positive attitude never

I. ATTITUDE (Please check the appropriate box)

1. Can you please enumerate desirable qualities in the workplace that the
applicant possesses?

Desirable Qualities 1 2 3 4 5
a.
b.
c.

2. Can you please enumerate undesirable qualities that the applicant

possesses which are detrimental to the organization?

Undesirable Qualities 1 2 3 4 5
a.
b.
c.

" TURNING YOUR VISIONS INTO REALITIES "

Lacaron, Malita, 8012 Davao Occidental
T (+639171141438) (+639632878013)
division.davaooccidental@deped.gov.ph
deped.davaooccidental.gov.ph
 Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO OCCIDENTAL

3. Was there a time when the applicant had misunderstanding or conflict

with his/her officemates? If yes what happened?
________________________________________________________________
_________________________________________________________________
_________________________________________________________________

4. Rate the applicant based on the following aspects (5 as highest, 1 as

lowest)

Areas 1 2 3 4 5
a. Personal grooming, hygiene
b. Respects the opinions of others especially with
superiors
c. Ability to deal with clients or stakeholders

II. WORK PERFORMANCE

Rate the following aspects/areas based on your observation or experience

with the applicant (5 as highest, 1 as lowest)

Areas 1 2 3 4 5
Punctuality in coming to work/office, office activities
Submission of required reports
Filing of benefits and leave applications
Office/table cleanliness

III. SUMMARY/RECOMMENDATION

1. State major findings based on Part I and II:

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

2. Recommendation:

Highly recommended
Recommended
Recommended with reservation
Not recommended

3. Reason/s for the recommendation

______________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

Conducted by: _________________________ Date: __________________

" TURNING YOUR VISIONS INTO REALITIES "
Lacaron, Malita, 8012 Davao Occidental
T (+639171141438) (+639632878013)
division.davaooccidental@deped.gov.ph
deped.davaooccidental.gov.ph
 Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO OCCIDENTAL

" TURNING YOUR VISIONS INTO REALITIES "

Lacaron, Malita, 8012 Davao Occidental
T (+639171141438) (+639632878013)
division.davaooccidental@deped.gov.ph
deped.davaooccidental.gov.ph