Employment Reference Check printable pdf download

Employment Reference Check

STATE OF UTAH

DEPARTMENT OF HUMAN RESOURCE MANAGEMENT

Employment Reference Check

Applicant Name:

Hiring Official:

Reference Name:

Position Title:

Reference Company:

Division / Office:

Reference Phone:

For Hiring Official

Use Only:

1. How would you describe the employee’s performance (i.e., quality and quantity)?

Acceptable

Questionable

Unacceptable

2. What was the employee’s reason for leaving?

Acceptable

Questionable

Unacceptable

3. Was the employee dependable as far as attendance is concerned?

Acceptable

Questionable

Unacceptable

4. Are you aware of any incidents of threats, intimidation, or violence involving this person?

Acceptable

Questionable

Unacceptable

5. How well did the employee provide customer service, whether internal or external to your

company?

Acceptable

Questionable

Unacceptable

6. Would you rehire the employee?

Acceptable

Questionable

Unacceptable

•

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Equal Opportunity Employer/Programs

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Employment Reference Check