Reference Check Form
► Source of the Reference
Name : Designation :
Relationship with candidate : Contact Info :
Company :
►Candidate’s Work Experience
Working Period :
Department, Position and Responsibilities :
Attitute and/or performance of his/her job :
Reason for leaving :
Strengths of the Candidate :
Areas where the Candidate can need to improved :
Relationship with Collegues, Internal / External Customers :
Has the Candidate gone through any disciplinary investigation during his/her tenture :
This person is considered for................... position. Do you think he/she would be suitable for this position?
►APPRAISAL BY CANDIDATE’S EX-SUPERIOR
Please give a score (from 1 to 5) for him/her considering our competencies indicated below? And please
share the reason with us.
..............................................................................................................
Continous Learning ..
.
..............................................................................................................
Communication ..
.
..............................................................................................................
Customer Focus ..
.
..............................................................................................................
Results Orientation ..
.
..............................................................................................................
Values and Ethics ..
.
How do you feel if he/she is given an opportunity to work with you again?
........................................................................................................................................................................
NOTES ( Any other points that you want to mention ) :
........................................................................................................................................................................