Full Name of Applicant

Reference Provided by: (Full Name)

Reference Contact Information

How do you know the applicant and for how long have you known them?

What were/are the applicant's job responsibilities?

Please list a few of the applicant's strengths.

Please list any of the applicant's weaknesses or areas for growth.

Why did the applicant leave your employment?

Would you consider re-hiring the applicant?YesNo

How would you rate the applicant in the following areas?

Any other comments?

Applicant Reference Form