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Reference Check Form 3

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Thais Varini
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16 views

Reference Check Form 3

Uploaded by

Thais Varini
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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REFERENCE REPORT

Name of Applicant: ____________________________________

Post Applied For: ____________________________________


Report by: ____________________________________
Position Held by Applicant: ____________________________________
Was this Temporary or Permanent: ____________________________________
Dates of Service: ____________________________________
Reason for Leaving: ____________________________________

ASSESSMENT (*Please mark appropriate column with an X)

CRITERION Poor Fair Average Good Excellent Cannot


Comment
Professional/Technical Knowledge
Professional Conduct
Organisation of Work
Administrative Skills
Accuracy/Attention to detail
Punctuality
Attitude to colleagues
Attitude to job
Willingness to take responsibility
Ability to work as part of a team
Ability to work to deadlines
Application of knowledge
Ability to teach students/staff
Ability to work on own initiative
Attitude to supervision and taking
correction
Interpersonal Skills
Communication Skills
Reliability/Responsibility
Integrity
Future Potential
Leadership Skills
Personal Presentation/Presence
Attendance Record
Sick Leave: Please specify number of
days and occasions:
Certified Sick Leave
Days ______ Occasions:________

Uncertified Sick Leave


Days ______ Occasions:________
How long have you known this person and in what capacity (employee, colleague, etc.)?

______________________________________________________________________________________________

In general what is your opinion of this person’s performance during his/her employment with your organisation?

______________________________________________________________________________________________

Would you recommend this person for the role of ___________________________________________________?

Yes No

If no, please provide details:

______________________________________________________________________________________________

______________________________________________________________________________________________

Do you know of any reason why we should not employ this person?

______________________________________________________________________________________________

______________________________________________________________________________________________

Would you re-employ this person? Yes No

If no, please provide details:

______________________________________________________________________________________________

______________________________________________________________________________________________

Please indicate any additional comments you may have regarding this person’s work performance

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

SIGNED: _______________________________ NAME: _______________________________

POSITION: _______________________________ COMPANY: ____________________________

DATE: _______________________________

Note: In certain circumstances verbal references shall be sought. In such circumstances the HR Department shall
complete the form and stamp where indicated below:

________________________________
Stamp, Signature and Date

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