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Reference Checking Form

The document is a reference checking form for human resource management, used to evaluate an applicant's past employment and performance. It includes sections for rating work performance, attendance, and dependability, as well as inquiries about criminal records and administrative cases. Additionally, it asks whether the former employee would be re-hired and requires signatures from the individual providing information and HRMD personnel.

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February
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7 views1 page

Reference Checking Form

The document is a reference checking form for human resource management, used to evaluate an applicant's past employment and performance. It includes sections for rating work performance, attendance, and dependability, as well as inquiries about criminal records and administrative cases. Additionally, it asks whether the former employee would be re-hired and requires signatures from the individual providing information and HRMD personnel.

Uploaded by

February
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

HUMAN RESOURCE MANAGEMENT AND DEVELOPMENT

REFERENCE CHECKING FORM

Applicant Name: Position Applied for:


Former Job:
Company Name: Job Title:
Company Address:
Department: Period of Employment:
Supervisor’s Name: Employment Status:
What was your relationship with the applicant?

I. Please rate the employee’s ability in the following areas. Each category is rated as follows:
4 – Outstanding 3 – Very Satisfactory 2 – Fair 1 – Poor

A. Work Performance
B. Initiative
C. Attendance
D. Dependability
E. Ability to learn new procedures
F. Willingness to take on additional responsibility
Total

II. Past record


Has a criminal record? [ ] No [ ] Yes If yes, pls. check appropriate box below
[ ] Estafa [ ] sexual harassment
[ ] Infliction of physical injuries [ ] Others, pls. specify:

Has pending administrative case: [ ] No [ ] Yes If yes, pls. check appropriate box below
[ ] Poor performance [ ] Habitual tardiness, Absenteeism
[ ] AWOL/Abandonment [ ] Others, pls. specify:

III. If this former employee will reapply to your company, will he/she be accepted?
[ ] Yes [ ] No If No, why? Pls. specify

Name and Signature of Position/Title


individual providing information

For UM HRMD personnel to fill in: BI conducted through:


[ ] Phone call [ ] Email [ ] Fax [ ] Mail [ ] Personnel visit

General Average Rate:


21 – 24 Outstanding
18 – 20 Very Satisfactory
14 – 17 Fair
0 – 13 Poor
Noted by:

HRMD Head Date

F-16100-034/ Rev. 3/ Effectivity: April 12, 2018

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