Employment Reference Request Form Check List

             Prior Employment Reference Request Form Check List

Make sure you have written and FCRA compliant permission from the applicant before proceeding with any kind of reference or employment background check.

Under no circumstances should you ask about an applicant's medical history or medical issues.

Identify yourself and explain that you are checking the applicant's references on behalf of a prospective employer.

A. Applicant's Name
______________________________________________________

B. Name Of Company
______________________________________________________

C. Name of Reference ______________________________________________________

1. Verify Employment Dates : From

When:__________________ To When:____________________

2. Name And Describe Positions Held And Work Performed.

______________________________________________________

3. Why Did Applicant Leave?
____________________________________________________

4. How did the applicant perform when stressful situations arose ?
____________________________________________________

5. How was applicant's relationships with fellow employees and supervisors.
_________________________________________________________

6. Was applicant responsible for supervising other employees?
__________________________________________________

7. Did the applicant produce an acceptable amount of work?
__________________________________________________

8. Describe the quality of the applicant's work product.
_______________________________________________________

9. Would you describe the applicant as a team player in most situations?
_____________________________________________________

10. Did the applicant prefer to work individually rather than in groups?
____________________________________________________

11. Describe the candidates contributions and major strengths.
_____________________________________________________

12. What weaknesses, if any, did the applicant display?
_____________________________________________________

13. How would you assess or describe the applicant as an employee overall?
___________________________________________________________

14. Describe the position the applicant is seeking and inquire  if the applicant would be suitable for this job.
__________________________________________________

15. If applicant is suitable, please explain why.
__________________________________________________

16. If applicant would not be suitable  please explain why.
__________________________________________________

17. Would you have any other comments or is there anything else we should be aware of about this applicant?
__________________________________________________

18. Do you think  this individual would be eligible for rehire at your business or organization? If this applicant would not be eligible for rehire, why not?
___________________________________________________

19. Can you think of anything else that a prospective employer would or should be aware of?
____________________________________________________

Completed by: ___________________________________ Date: _____________________

__________________________________________________________


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Disclaimer
None of the information contained in this web site should be construed as legal advice.
All forms, policies, information and procedures should be reviewed by your legal counsel before being used in any way.

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