Reference check form

Name of Recruitment Officer: *


Name: *

Position applied for: *


Name *

Position *

Phone number mobile: *

Phone number landline: *

Organisation *


My name is <your name> and I'm calling to conduct a reference check for <name of candidate> who is being considered for a position with Cara. Your details have been provided to me by <candidate name>. The reference will take no longer than ten minutes is this a good time for you?


Please note that this reference will be used in the overall evaluation of the applicant and will affect whether they are selected for the job. The information you provide may be given to the candidate if requested, Do I have your permission to proceed?”


What is the nature of your relationship with the candidate? *

In what capacity is/was the applicant employed by your organisation? *

Did you supervise the candidate directly? *

If you didn't supervise the candidate directly what was your working relationship with them?

How long did the candidate work with you? *

What were the key tasks of their role during this time? *

Why did they leave the organisation? *

Have you had any areas of concern? *

How would you rate their reliability and attendance? *

What concerns did you have? (ask only if rated this way)

How would you rate their professionalism? *

What concerns did you have? (ask only if rated this way)


Please rate the following areas on a scale of 1-5 with 1 being well below expectations and 5 being well above expectations *

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Communication Skills
Customer person centred focus
Internal Collaboration and team work
Ability to work under pressure
Resilience
Ability to work under minimal supervision
Problem solving
Ability to learn, retain and apply information
Commitment and loyalty
Empathy

Based on the information above please supply detailed information for extreme responses


Please rate the following areas between 1-5 where 1 is well below expectations and 5 is well above expecatations *

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How well did the respond to feedback?
Did they achieve key performance outcomes?
Did they contribute to any tasks outside of their role?
Did they adapt well to their role?
Did they adapt well to change?

Based on the information above please supply detailed information for extreme responses


Would you re-employ <name of candidate>? Why/why not? *


Thank you for your time today