Fillable Printable Basic Reference Check Template
Fillable Printable Basic Reference Check Template
Basic Reference Check Template
Reference Check Template
Section I: Applicant Information
___________________________ __________________________
Last Name First Name
_________________________________________________________________
Position title College/Org and Department/Unit
Section II: Reference Contacted
__________ ______________ ___________________________ ________________
Person Contacted Employer/Organization Phone Number
____________________________ ________ ___________________
Position title of person contacted: Length of Association to Candidate
Relationship to candidate: □ Supervisor □ Co-Worker □ Academic □ Other
Describe: ______________________
Section III: Candidate Information
Reference must be work relevant or related to academic background
_________________________ __________________ _________________
Position title candidate held Employer/Organization Dates of Employment
Identify yourself, your role at Trent, your reason for calling and the position for which the
candidate is applying. If necessary, briefly describe the duties and responsibilities of the position
the candidate is seeking.
REFERENCE CHECKLIST
Does summary given by candidate accurately
reflect his/her duties and responsibilities?
o Checks
o Doesn’t Check
Why did this he/she leave? o Checks
o Doesn’t Check
How quickly does he/she learn new tasks?
What level of supervision did he/she require?
o Excellent
o Good
o Poor
o Little or no supervision
o Occasional Supervision
o Excessive Supervision
How would you compare candidate’s abilities
with others that have held the job?
o Excellent
o Good
o Poor
Overall, how would rate his/her work habits?
Dependability?
Trustworthiness?
Initiative?
o Excellent
o Good
o Unsatisfactory
o Excellent
o Good
o Unsatisfactory
o Excellent
o Good
o Unsatisfactory
o Excellent
o Good
o Unsatisfactory
How would you rate his/her punctuality and
attendance?
o Excellent
o Acceptable
o Below Average
Rate his/her time management and
organizational skills.
o Excellent
o Acceptable
o Below Average
How would you rate his/her interpersonal
communication skills?
Comments?
o Excellent
o Good
o Unsatisfactory
Assess candidate’s ability in relating to
peers/students.
Comments?
o Excellent
o Good
o Unsatisfactory
Rate candidates written skills.
Rate candidate’s verbal skills.
Comments?
o Excellent
o Good/ Satisfactory
o Unsatisfactory
o Excellent
o Good/Satisfactory
o Unsatisfactory
Adaptability to change? o Excellent
o Acceptable
o Below Average
Overall, how would rate the quality of work
performed?
Comment?
o Consistently high quality
o Meets job requirements
o Needs improvement
Describe the candidate’s ability to make sound and timely decisions.
Comment on the candidate’s ability to cope in a diverse and complex work environment.
What areas could the candidate improve upon?
Was the candidate the subject of any disciplinary action or legal proceedings? If yes, please
briefly describe the circumstances and the outcome.
Would you rehire this person? If no, why not?
Is there anything else you would like to add?
____________________________________ __________________
Signature of Person Checking References Date
