Reference check template

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?

In accordance with the Privacy Act, we wish to inform you that the information collected may be shared with personnel of Cara, and the candidate may also lodge a request to our Privacy Officer for access to this information. Based on the above are you happy 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? *

How long did the candidate 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 reliability attendance? *

How would you rate professionalism? *

Communication skills *

Customer person centred focus

internal collaboration and teamwork

Ability to work under pressure


Ability to work under minimal supervision

Problem solving skills

Ability to learn, retain and apply information

Commitment and loyalty


Build working relationships with external stakeholders

Honesty and integrity

Based on the information above plesae supply detailed information for extreme responses:

Is there any further information you would like to provide? *

How well did they respond to feedback? *

Did they achieve key performance outcomes? *

Did they contribute to any tasks or projects outside of their role? *

Did they adapt well to their role? *

Did they adapt well to change? *

Based on the above information please provide any detail for extreme responses *

Based on the reference check you have provided would you recommend them to us and would you re-employ them? *

Thank you for your time today

Overall rating *

Name of Recruitment Officer: *