Reference Check Template

  Section 1: Applicant Information

Last Name:

 

 First Name, and Middle Initial:
Position Title:

College/Organization/Department/Unit:

 
  Section 2: Reference Contacted
Name:

Employer/Organization:

Telephone Number:

Position Title of Reference:

 

 Length of Association to Candidate:
   

Section 3: Candidate Information

Reference must be work relevant or related to academic background.

Position Title Candidate Held:

 

 Employer/Organization: Dates of Employment:

Identify yourself, your institution, 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.

 

  1. Briefly provide the reference with a summary of the candidate’s statement of his/her duties in the former position.  Does this summary accurately reflect the candidate’s duties and responsibilities?

 

 

 

  1. Did you have an opportunity to observe and evaluate the candidate’s performance?  If yes, how would describe the candidate’s work performance in this position?

 

 

 

  1. How would you compare the work performance of this candidate with that of others who have held the same position?

 

 

 

  1.  Describe the candidate’s knowledge, skills and subject matter expertise.

 

 

 

  1. What areas could the candidate improve upon?

 

 

 

  1. Please provide examples of the candidate’s experience with and/or commitment to diversity in the work/academic environment.  

 

 

 

  1. Describe the candidate’s work ethic in the context of trustworthiness, dependability and initiative.

 

 

 

  1. How would you rate the candidate’s writing and verbal communication skills?

 

 

 

  1. How would you rate the candidate’s interpersonal communication skills?

 

 

 

  1.   How would you describe the candidate’s relations with his/her customers?

 

 

 

  1.   How would you rate the candidate’s time management/organization skills?

 

 

 

  1. Describe the candidate’s ability to make sound and timely decisions.

 

 

 

  1. Describe the candidate’s adaptability to change.

 

 

 

  1. If known, why did the candidate leave your employ?

 

 

 

  1. Is the candidate eligible for rehire?  If no, can you share the reasons why not?

 

 

 

  1.   Is there additional information that you would like to provide that would be pertinent in considering this candidate for employment?

 

 

  Section 4: Required Signature
Date: Signature of Person Checking References: