Employment Reference Check Form



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PROFESSIONAL WORK EXPERIENCE DOCUMENTATION DOCUMENTATION Applicant: Position: Reference Contacted: Name: Telephone Number Title of Reference: Employer: Verify the following information: Position Applicant Held: Relationship to Applicant: Supervisor Co-worker Professional Date of Employment: From To How long did you supervise or work with: Ask the employer for information on the applicant on the following areas/Tell me about:  Attendance:Dependability:  Ability to take on responsibility:  Cooperation within the department/campus:  Give pertinent examples showing initiative:  Degree of Supervision needed:  Job Knowledge – (State the position the applicant is recommended for - Inquire on the specific job duties they were/are responsible for that may be relevant to recommended position)  Quality of Work (multi-task, attention to detail, customer service, operate office equipment, ability to learn new tasks):  Areas for improvement What was

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