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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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.