HPS REFERENCE CHECK FORM
Hello from HPS!
Your details have been provided to us by the below mentioned applicant who is currently being
considered for a position with HPS.
We would greatly appreciate if you could complete this reference check form and return it
via email to
It should take approximately 10 – 15 minutes to complete, and will be used in the general
evaluation of the applicant for the position they have applied for.
Please note, under the Freedom of Information Act, the information you provide may be given
to the applicant if requested.
If you have any further questions, please let me know.
Thank you in advance for your time and cooperation.
Applicant Details
Applicant Name: mary Hanna
Position Applied For: Pharmacy technician
Reference Check Form
General Questions
1. What is the nature of your relationship with the applicant? Did they report to you directly?
I was the project manager and direct supervisor of the work of volunteer Mary Hanna.
2. In what capacity is/was the applicant employed by your business?
Psychosocial Facilitator
3. What were the approximate dates of their employment?
From 03/2017
Until 02/2019
4. What is/was the applicant’s reason for leaving?
the reason was to travel and leave the country to Erbil
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Job Related & Performance Questions
1. What duties and responsibilities does/did the applicant have?
1- Prepared, planned for daily group activities following multiple psychosocial programs to
help children and teenagers improving their mental health
2- Provided high standards care for children who have been exposed to domestic violence
or special circumstances
3- Work within an educational program
4- she also worked in programs to support women who were exposed to violence
5- Arranged community events to increase the awareness of mental health,
2. How would you describe the applicant’s overall work performance?
she is very committed to work and appointments and has the ability to withstand work
pressures
3. How would you describe the applicant’s ability to work in a demanding environment?
it is able to work in all conditions .
4. What would you say are the applicants’ strengths?
Mary is strengths 1- Ability to carry out work
2- good adherence to work deadlines
3- the spirit of teamwork and joint work
5. What would you say are the applicant’s developmental areas (e.g., weaknesses)?
A very helpful girl who finds it difficult to say "no" when someone asks her for
something, and ends up doing more tasks than she can handle .
6. Have you had any concerns with their performance?
If yes, please explain when these issues were identified? When were they discussed with the
individual? What work are their doing to improve and what progress has been made?
There are absolutely no fears. She is a hardworking girl and always seeks to develop
her skills .
Teamwork & Customer Service Questions
1. Can you describe the applicant’s ability to build rapport with colleagues / managers / supervisors?
Mary has a very good professional communication style
she has experience working with the group well and professionally
2. Can you describe the level of contact the applicant had with Customers / Clients?
Her style was very gentle in communicating with beneficiaries and she had experience
in gaining people's trust.
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Personal Trait Questions
1. Can you comment on the applicant’s:
o Reliability
o Punctuality
o Attendance
o Professionalism
o Attention to detail
1- very good
2- Excellent
3- very good
4- very good
5- Excellent
2. Can you please describe the applicant’s ability to take direction and follow instructions?
she is very good at following instructions, committed to decisions, and contributes to
improving work performance .
In Closing Questions
1. Would you re-employ the applicant? Why/why not?
Yes, of course . She is a talented girl and has mastery in her work .
2. Is there anything further that you would like to mention about this applicant?
NO , nothing
Reference Check Completed By:
Rojeh zitouny
Referee Name:
Position Title: Project Manager
Company / Organisation: Syrian Society for Social Development
Date Completed: 08/07/2024
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