6 th Floor, HD Tower
25 bis Nguyen Thi Minh Khai Street, Ben Nghe Ward, D1, HCMC, 700000
Tel +84 28 3622 0899 | Fax +84 28 3911 6270 | [Link]/vietnam
CONFIDENTIAL REFERENCE QUESTIONNAIRE
In order to provide thorough services to our clients, we would appreciate your assistance in the completion
of this questionnaire. All the information provided is treated in the strictest of confidence and used only in
conjunction with our business.
Candidate Information
Candidate’s Name:
EMPLOYER INFORMATION:
Company Name:
Supervisor:
Designation: Telephone:
INFORMATION RE-CANDIDATE PERFORMANCE:
Position:
1. Please confirm dates of Employment:
2. Primary Responsibilities:
3. What was the final salary:
4. Why did he/she leave?
5. Did he/she have any personal problems
that interfered with job/company?
6 th Floor, HD Tower
25 bis Nguyen Thi Minh Khai Street, Ben Nghe Ward, D1, HCMC, 700000
Tel +84 28 3622 0899 | Fax +84 28 3911 6270 | [Link]/vietnam
Please tick the appropriate box and provide comments where applicable
Excellent Good Fair Poor
6. How did he/she get along with other people?
Yes No Other
7. Is he/she a quick learner?
8. Do you think that he/she has an
Yes No Other
aggressive/initiative personality and able to work
without supervision?
9. How would you evaluate his/her attendance and Excellent Good Fair Poor
punctuality?
10. Would you have considered a promotion for Yes No
him/her if an opportunity arose?
✘ Yes No
11. Would you consider re-employing him/her?
12. What would you consider his/her strengths and weakness’ to be?
Strengths:
Weaknesses:
6 th Floor, HD Tower
25 bis Nguyen Thi Minh Khai Street, Ben Nghe Ward, D1, HCMC, 700000
Tel +84 28 3622 0899 | Fax +84 28 3911 6270 | [Link]/vietnam
13. How would you evaluate his/her overall Excellent Good Fair Poor
performance?
14. Did you do a reference check with his/her Yes ✘ No
previous employer before hiring?
15. Do you have any other additional comments?