REFERENCE CHECK FORM
Name of Candidate
Name of Referee
Designation of the Referee
Telephone no.
Email address
Date
Please comment on the following
Relationship and the length of
time you’ve known him/ her.
Efficiency and general standard
of work (if any)
Key working strengths
Key working weaknesses / Areas
for development/ improvement
Any other information
Reason for leaving
Please rate the following capabilities on a scale of 1 (weak) – 10 (strong) and include the
supporting explanation/justification against each capability:
ASSESSMENT
POINTS JUSTIFICATION / EXPLANATIONS
Honesty and integrity
Planning and organising
and decision skills
Capacity building and
mentorship skills
Continuous learning and
improvement
Attitude and commitment to
work
Team work and Leadership
skills
Interpersonal skills
Attention to details
Add separately and attach to this form, any other information that could assist us in assessing
the Candidate.
NAME_______________________________SIGNATURE:________________DATE________
Official stamp if possible