Employee Work Reference Inquiry Documentation Form

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Employee Work Reference Inquiry Documentation Form
Instructions: Use this form to document any work references provided to prospective employers for current or former employees. See
for guidelines and information about providing to work references to prospective
employers.
This form must be retained in the employee’s departmental personnel file and made available to the employee for viewing upon the employee's
request.
Employee Name:___________________________________________
Date
Date
Name of Person Requesting Work
Reference
Name of Prospective
Name of UW Reference Provider
Job Title of UW
Reference
Reference
Requester Job Title
Employer
Reference Provider
Provided

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