Reference Check

You are receiving this survey because Mr.Ardinus Sitohang has listed you as his reference in your company.

Part1：Previous Employer`s Contact Information

Company name

Your Name Your Position

Part2：Employment Verification of Ardinus Sitohang

Term of Employment (D/M/Y)

Position

Main Duties

Compliment or Complaint and Punishment

Salary Range

Reason for Leaving

Completion of Duties Transition after Resignation

Any Labor Disputes with Your Company or Any

Malpractices?
Your Willingness of Rehiring (Yes/No)

Part3： Please rate the candidate from 1 to 5 (1 being the lowest, 5 the highest) on the following by
inserting “Yes” in the correspondent columns.

5 4 3 2 1

Work
Performance
Work
Efficiency
Work
Skills
Integrity

Interpersonal
Skills
Work Ethics

If there are any other comments about the candidate`s potential improvements and concerns you
would like to make, please leave it below. Thank you!

We appreciate any information or suggestions you may provide and are grateful for your help.