Fillable Printable Pre-Employment Reference Check Form

Pre-Employment Reference Check Form

CANDIDATE’S NAME:

HIRING DEPT:

POSITION SOUGHT:

ORGANIZATION NAME & LOCATION:

CANDIDATE’S DATES OF EMPLOYMENT CONFIRMED AS:

FROM: TO:

CANDIDATE’S LAST JOB TITLE CONFIRMED AS:

CANDIDATE’S LAST RATE OF PAY CONFIRMED AS:

END OF EMPLOYMENT REASON CONFIRMED AS:

ELIGIBLE FOR REHIRE?

YES NO

NAME OF REFEREE:

PHONE NUMBER:

TITLE OF REFEREE:

RELATIONSHIP TO CANDIDATE:

DESCRIBE THE JOB THAT THE CANDIDATE IS BEING CONSIDERED FOR, AND ASK THE REFEREE TO COMPARE AGAINST

DUTIES PERFORMED IN THE JOB THE CANDIDATE DID FOR THEM:

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COMMENTS ON LEVEL OF TECHNICAL SKILLS & EXPERTISE THAT WILL BE RELEVANT TO SWARTHMORE JOB:

COMMENTS ON PROFESSIONAL INTERACTIVE SKILLS THAT WILL BE RELEVANT TO SWARTHMORE JOB:

ANY DOCUMENTED CONCERNS ABOUT: YES**

ATTENDANCE, PUNCTUALITY OR RELIABILITY OTHER THAN FOR LEGITIMATE

MEDICAL OR FAMILY LEAVE REASONS?

INTEGRITY OR EFFECTIVENESS IN HANDLING THE ORGANIZATION’S RESOURCES

FOR WHICH THEY WERE RESPONSIBLE?

INTREGRITY OR EFFECTIVENESS IN THE PROFESSIONAL INTERACTIONS FOR WHICH

THEY WERE RESPONSIBLE?

THE ABILITY TO ACCEPT RESPONSIBILITY OR MAINTAIN PRODUCTIVITY ON THE

ASSIGNMENTS FOR WHICH THEY WERE RESPONSIBLE?

THE ABILITY TO EXHIBIT MATURITY, COMPOSURE, OR PROFESSIONAL CONDUCT

UNDER TYPICAL JOB STRESSES OR CHALLENGES?

THE ABILITY TO ADAPT SUCCESSFULLY TO NEW OR CHANGING WORK SITUATIONS:

PEOPLE, IDEAS, OR STRUCTURES?

** IF YES TO ANY, NOTE REFERRE’S COMMENTS OR CONCERNS:

OTHER COMMENTS ABOUT WHETHER YOU WOULD RECOMMEND THIS PERSON FOR THIS JOB?

REFERENCE CHECKED BY: DATE: