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Employee Reference Check Form Template

This employee reference check form collects information about an applicant from a previous employer. It asks about the applicant's dates of employment, job position and performance, reasons for leaving, strengths and limitations, ability to work with others, and ratings in areas like attendance, dependability, and potential for advancement. The referee is also asked if they would rehire the applicant and if there is any other significant information that could impact the applicant's performance if hired.

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Usha Tiwari
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1K views

Employee Reference Check Form Template

This employee reference check form collects information about an applicant from a previous employer. It asks about the applicant's dates of employment, job position and performance, reasons for leaving, strengths and limitations, ability to work with others, and ratings in areas like attendance, dependability, and potential for advancement. The referee is also asked if they would rehire the applicant and if there is any other significant information that could impact the applicant's performance if hired.

Uploaded by

Usha Tiwari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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[insert organisation name/logo]

Employee Reference Check Form

Name of Applicant:

Person Contacted:

Company:

Position/Title: Phone:

Relationship to applicant:

1. How long has it been since you last spoke with the applicant? (Were you aware they
had put you down as a referee for this application?)

2. What were the dates of his/her employment with you?

3. What was the nature of his/her job? (Describe position applied for - Do you think they
would suit this sort of role)

4. How would you describe his/her performance in comparison with other people?

5. Why did he/she leave your company?

Reference Check Template [month/year] Page 1 of 2


6. Would you re-employ?

7. What are his/her strong points and limitations?

8. How did he/she get along with other people?

9 Please rate the following on a scale of 1-to-10: (1=very poor, 10 = exceptional)

Score Comment

a) attendance 1 2 3 4 5 6 7 8 9 10

b) dependability 1 2 3 4 5 6 7 8 9 10

c) ability to take on
1 2 3 4 5 6 7 8 9 10
responsibility
d) conflict resolution 1 2 3 4 5 6 7 8 9 10

e) potential for
1 2 3 4 5 6 7 8 9 10
advancement
f) degree of supervision
1 2 3 4 5 6 7 8 9 10
needed
g) overall attitude 1 2 3 4 5 6 7 8 9 10

10. Is there anything else of significance which may impact their performance within
[insert organisation name] if they are successful in the role?

Reference checked by: Date:

[insert organisation name] Reference Check Form Page 2 of 2

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