[Verify that the applicant has provided permission before conducting reference checks and complete this top section initially from candidate's application, resume or interview notes.]
Candidate Name______________________________________________________
Reference Name______________________________________________________
Company Name______________________________________________________
Dates of Employment: From:__________________ To:____________________
Position(s) Held______________________________________________________
Reason for Leaving____________________________________________________
[Explain the reason for your call and verify the above information with the supervisor, including the reason for leaving. Note any differing or new information below.]
Please describe the type of work for which the candidate was responsible.
How would you describe the applicant's relationships with co-workers, subordinates (if applicable) and superiors?
Is the candidate more of an individual contributor, or is he or she more team-oriented? Why do you think so?
Was the candidate in a lot of high-pressure or stressful work situations? If so how did the candidate handle these situations?
How would you describe the quantity and quality of output generated by the candidate?
What were the candidate's strengths on the job?
What were the candidate's weaknesses on the job?
What is your overall assessment of the candidate?
Did the candidate have any warnings or discipline regarding unexcused attendance issues (frequent absences, tardiness, etc.)? [Do not ask about or discuss medical issues.]
The candidate has applied for a position as a ____________ with our company. Do you believe the candidate would be a good fit for this type of position? Why or why not?
Would this individual be eligible for rehire at your organization? Why or why not?
Is there anything I haven't asked about that someone considering this person for a job should be aware of?
Completed by: ___________________________________ Date: _____________________
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