PRE-EMPLOYMENT REFERENCE CHECK VIA PHONE (TYPE B)

 

Applicant: ________________________

 

Position: _________________________

 

Company Contacted: ______________________       Phone: _________________

 

Name of Company Representative: ___________________________

 

Title of Company Representative: ____________________________

 

Dates of Employment - From: _______________ To: _____________

 

Salary Information:

 

Regular Pay: ______________  Overtime Pay: __________________

 

Bonus: ____________________  Shift Differential: _______________

 

Date of last wage increase: __________________________________

 

What was your relationship with the applicant?  _____________________________ ___________________________________________________________________

 

What were the applicant's job title and duties?  ______________________________ ____________________________________________________________________ ___________________________________________________________________

 

How long did you supervise this employee?  ________________

How would you compare this employee to others doing similar work and responsibilities? ___________________________________________________________________ ___________________________________________________________________

 

Strong Points: ________________________________________________________ ____________________________________________________________________ ____________________________________________________________________

 

Areas for Improvement: _________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

 

How would you rate this applicant's ability on a scale of 1 to 5 (1 being the lowest) regarding the following:

 

Attention to Detail          _____       Comment   _______________________________

 

Learn                               _____       Comment   _______________________________

 

Follow Directions          _____        Comment   _______________________________

 

Accept Responsibility    _____       Comment   _______________________________

 

Follow Through             _____       Comment   _______________________________

 

Initiate                           _____        Comment   _______________________________

 

Supervisory Duties: _____________________________________________________ _____________________________________________________________________

Supervisory Ability: _____________________________________________________ _____________________________________________________________________

 

Leadership Potential: ____________________________________________________ _____________________________________________________________________

 

Attendance / Punctuality: _________________________________________________ _____________________________________________________________________

 

Ability to Work With Others: ______________________________________________ ______________________________________________________________________

 

Reason for Leaving: _____________________________________________________ ______________________________________________________________________

 

Would you Rehire: _____________________________________________________ _____________________________________________________________________

 

Other Comments: _______________________________________________________ ______________________________________________________________________

 

References Checked by: __________________________________________________

 

Date: __________________