REFERENCE CHECK FORM

SECTION I: CANDIDATE INFORMATION

Last Name: First Name:

Position applied for: Department:

SECTION II: REFERENCE CONTACTED

Person Contacted: Employer/Organization: Phone Number:

Position title of person contacted: Length of association to candidate:

Relationship to candidate: □ Supervisor □ Co-Worker □ Subordinate □ Other _____________________

Date Contacted: ___________________

SECTION III: QUESTIONS

1. Please describe the candidate’s main job responsibilities:

2. What can you tell me about [NAME]? How would you describe (his or her) character?
3. How would you describe the working relationships [NAME] had with other people in the organization?

o Excellent
o Good/Met expectations
o Unsatisfactory
o Not applicable

4. What was (his/her) biggest or most important contribution to the department and/or organization? What
were their key accomplishments?

5. In what area(s) did (he/she) excel in? What area(s) of development could the candidate focus on?

6. Describe [NAME]’s attendance at your organization.

o Excellent
o Good/Met expectations
o Unsatisfactory
o Not applicable

7. If provided the opportunity would you re-hire/work with (him or her)? Why or why not?

2
8. How did [NAME] perform while working with others? (Did they take initiative? Did the candidate mainly work
independently or within a group? Did he/she need a lot of direction?)

o Consistently high quality

o Meets job requirements
o Needs improvement
o Not applicable

9. If you were going to provide advice on how to best manage this person, what would it be?

10. If I describe the position we are hiring for to you, could you describe how good a fit you think he/she would be
for this position?

11. Additional comments provided by reference on any of the above questions or other job relevant information
gathered or inquired:

SECTION IV: ADDITIONAL DETAILS

Reason for leaving the

company:
Completed by: