Fill and Sign the Check Format Form

REFERENCE CHECK FORMAT FORM Introduce yourself and explain your purpose:  “My name is _______________ . I am a (working title) _______________ at Insert Name of Company .  We are interviewing for a vacant _______________ position in the _______________ department.  (candidate name) _______________ is one of the candidates being considered for this position.  (He/she) has named you as a reference and has given us permission to contact you. Are you available to answer some job-related questions about (him/her)? (If yes, continue) 1) In what capacity have you known or worked with _______________ ? 2) How long have you known (him/her)? _______________ How long have you worked with him/her? _______________ (Or you can state the job title, employment dates, and job duties specified in the application, and ask for verification) A.) Verify salary: _______________ B.) Where appropriate, check/verify educational degrees: _______________ I’d like to briefly describe the duties of position for which he/she has applied. They include: (Describe the focus/area of the job and/or key duties.) a)       b)       c)       d)       e)       3) Based on this job description, will you please assess the candidate in relation to the following required, job- related skills and abilities. On a scale of 1 to 10, with 1 being lowest and 10 being highest, how would you rate (him/her) on the following: (List the most important advertised skills, knowledge, and abilities) Rating a)             b)             c)             d)             e)             f)            Candidate’s Name:       Date and Time:       Name of Reference:       Reference’s Phone Number:       4) Would you like to add any comments in relation to these required skills? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 5) What are this individual’s strength’s and weaknesses? Strengths: Weaknesses a)       a)       b)       b)       c)       c)       d)       d)       6) If you had a position vacancy, would you re-hire this individual? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 7) Due to increased concern about violence in the workplace, it is our company’s practice to ask the following question for all persons being considered for hire: “Did you ever observe or notice in this individual a tendency toward violent behavior?” Record Answer: ______________________________________________________________________ Close the interview: That was the last of our questions. We want to thank you very much for your time and assistance in our recruitment effort.