Form Center

2. 1. Candidate
4. Name of Employment Candidate:*
8. 2. Reference Information
10. Reference Name:*
12. Phone Number:*
14. Email Address:*
16. Name of the organization you were affiliated with while working with this candidate:*
20. 3. Standard Questions & Reference Comments
22. Did you directly or indirectly supervise the candidate?*

    1. Directly
    2. Indirectly
24. Is the candidate eligible for rehire at the organization where you both worked together?*

    1. Yes
    2. No
    3. Unknown
26. If no, please describe.
28. Please describe the nature of the candidate’s job in your organization.*
30. Are you, or have you been made aware of any attendance issues?*

    1. Yes
    2. No
32. If yes, please describe.
34. Are you, or have you been made aware of any performance issues? *

    1. Yes
    2. No
36. If yes, please describe.
38. Please rate the candidates problem-solving skills between 1 and 5. *
    -- Select One --12345

    5 being the most proficient and 1 being the least proficient

40. Please rate the candidate’s quantity of work between 1 and 5.*
    -- Select One --12345

    5 being the most proficient and 1 being the least proficient

    
    

42. Please rate the candidate’s quality of work between 1 and 5.*
    -- Select One --12345

    5 being the most proficient and 1 being the least proficient

    
    

44. Please rate the candidate’s interpersonal skills/ability to work with others between 1 and 5.*
    -- Select One --12345

    5 being the most proficient and 1 being the least proficient

46. Please rate the candidate’s communication skills between 1 and 5.*
    -- Select One --12345

    5 being the most proficient and 1 being the least proficient

48. Are there any additional comments you’d like to provide that might assist us in making a hiring decision?*
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field