Ref Check
Ref Check
Purpose: A reference check is a valuable tool in the recruitment process to verify facts and obtain additional information about the candidate. All sections should be completed to be considered a valid reference. Indicate N/A if the question is not applicable. DO NOT CONDUCT A CHECK WITHOUT A COMPLETED APPLICATION FROM PITTSOURCE. Applicant Name:___________________________ Date of Reference Check:_______________________ Reference Name:______________________________ Relationship to Applicant: Supervisor Peer Person Checking Reference:______________________ Reference Organization:_________________________ Other (Specify)______________________________ Salary:______________________________________
Dates of Employment: From ________To__________ Position(s) Held: What was the nature of the applicants job? Reason for Separation: Give Explanation: Voluntary
Involuntary
____________________________________________________________________________________________________________ Please rank the candidate based on the following areas: Responds to Supervision Attendance Dependability Willingness to assume responsibility Ability to follow instructions Quality of work Quantity of work Poor Poor Poor Poor Poor Poor Poor Fair Fair Fair Fair Fair Fair Fair Good Good Good Good Good Good Good Very Good Very Good Very Good Very Good Very Good Very Good Very Good Excellent Excellent Excellent Excellent Excellent Excellent Excellent N/A N/A N/A N/A N/A N/A N/A
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Additional Questions: Were there any disciplinary actions? Please explain:
If given the opportunity, would you re-employ this individual? Any additional comments?
Yes
No