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Applicant Reference Check

PPLICANT

EFERENCE

HECK

Applicant Name:___________________________________________ Date:_________________

Position Applied For:______________________________________________________________

Reference:

___Current Employer

___Previous Employer

___Professional

___Personal

Name of Reference:_______________________________________________________________

Organization/Business:____________________________________________________________

1. Describe applicant’s job duties and responsibilities, if applicable.

2. Would the applicant be successful in the position for which he or she is being considered? Why or why not?

3. Describe how the applicant interacts with others.

4. Do you feel the applicant is trustworthy? Please give examples:

5. The applicant would be working with young children. Would you feel comfortable having the applicant as a

caregiver to a child of your own or a child close to you? Please explain:

6. Please describe the applicant’s strengths.

7. Is the applicant dependable? Why or why not?

I certify that I personally contacted the reference listed on this form and accurately recorded the information

provided.

Staff Name:_________________________________

Staff Title:_______________________________

Applicant Reference Check