Candidate Information

First name

Last name

Your Information

Company Name

Job Role

Email

Phone Number

Company address inc. postcode

Relationship to applicant

e.g. team leader, supervisor etc.

How long have you known the applicant?

What are/were responsibilities of the applicant?

Start of Employment

End of Employment

Reason for leaving

Were there any documented disciplinary actions?

Yes

No

If answer is yes, please state details below.

Is the applicant available for rehire?

Yes

No

How does/did the applicant respond to critical feedback?

Is there anything else to be taken into consideration?

Thank you for taking the time to complete this employee reference form. It's critical to us to get reference feedback for our potential employees.

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Signature

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