Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO DEL NORTE

BACKGROUND INVESTIGATION FORM

Level:
Name:________________________________________
Gender:_______________________________________
Position applying for:_____________________________ Work Relationship to the applicant (please check
appropriate box):
Respondent: Supervisor of the applicant
Name:_________________________________________ Peer of the applicant
Position:_______________________________________ Subordinate of the applicant
_
Company/Organization: ___________________________ others
Years/ months working with the applicant:_____________

Rating:
5-Exhibits positive attitude consistently 2-Exhibits positive attitude rarely
4-Exhibits positive attitude most of the time 1-Never exhibits positive attitude
3-Exhibits positive attitude sometimes

I. ATTITUDE (Please check appropriate box)

1. Desirable qualities of applicant in the workplace. To be rated from 1 to 5, 5 is the highest.

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

2. Undesirable qualities that the applicant possesses which are detrimental to the organization.

Undesirable Qualities
a.
b.
c

3. Situation when the applicant had a misunderstanding or conflict with his/her officemates if there is any. What
happened?
4. Rate the applicants based on the following aspects (5 as highest, 1 as lowest)

Areas 1 2 3 4 5
Personal grooming
Respects the opinions of others especially with superiors
Ability to deal with clients or stakeholders

II. WORK PERFORMANCE

Rate the following aspects/ areas based on your observation or experience with the applicants (5 as highest, 1
as lowest)

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

III. SUMMARY/ RECOMMENDATION

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

2. Recommendation:

Highly recommended
Recommended
Recommended with reservation
Not Recommended

3. Reason/s for the recommendation:

Conducted by :_______________________ Date:____________________

-Nothing Follows-