Employment History Verification Template
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1
2TEXAS TECH UNIVERSITY
EMPLOYMENT HISTORY VERIFICATION
Applicant Name:
____________________________________________
SSN:
__________________________
Position Applied For:
________________________________________ Req.#:_________________________
Employer:
__________________________________________________________________________________
Name of Person Contacted:
___________________________________________________________________
Relationship to Applicant:
Supervisor
Co-Worker
Other (explain):
Contact Date:
______________________
Time:
______________________
Verify the following from the Employment Application. Use the Comments/Explanations section to explain “NO” answers.
VERIFIED
ITEM TO BE VERIFIED
COMMENTS/EXPLANATIONS
YES
NO
Title
Dates of Employment
Full or Part Time (# of
Hours)
Start and Final Salary
Supervisory Responsibility
Job Duties
Reason for Leaving
OPTIONAL QUESTIONS:
Was overall performance satisfactory?
Yes
No (If No, Explain):
Would you rehire?
Yes
No (If No, Explain):
Do you have any additional comments or recommendations regarding this individual?
Verification completed
by:_________________________________________ Date:______________________
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