Reference Verification Reference Verification Form Your Contact InformationYour Name First Last Your Email Your Phone NumberReference QuestionsCandidate Name First Last 1. What is your lasting impression of this individual?2. What is the name of your organization and how long did the candidate work there?3. Did the candidate report directly to you during their time at your organization?YesNoIf no, how long were you their direct supervisor?4. If you were not the direct supervisor, how familiar are you with the candidate's work?5. What were the candidate's responsibilities in their position?Using a scale of 1 to 5, how would you rate this person's overall quality of work? (Five indicates very high quality)12345Please share a specific example that justifies this rating:7. Describe one major accomplishment this individual achieved while you were their supervisor.8. Give an example of a time they demonstrated initiative at work.9. What areas for development were highlighted during performance appraisals for this candidate?10. Describe this person's interpersonal and communication skills.If yes, please describe:11. To your knowledge, did they ever have any serious conflicts at work?YesNo12. How well does this person cope with changes in the work environment, stressful situations, or urgent assignments? Was pressure/stress a significant part of their role?13. Describe this person’s critical thinking and problem-solving skills. Can you provide an example where they demonstrated these skills?14. Why did this person leave your organization? (If still employed, why do you think they may be seeking other opportunities?)15. If you had a position available, would you re-hire this person?YesNoIf not, why?16. Did you ever have any concerns surrounding their attendance or punctuality?YesNoIf yes, please explain:17. Did this person ever require disciplinary measures? If so, please describe.18. Did you ever have any concerns about their attention to safety in the workplace?YesNoIf yes, please explain:19. Is there anything else about this candidate that a prospective employer should know?Additional Comments: (please provide any additional comments or details that may be helpful)
