Reference Form

New Hire Reference Form

Who are you filling out this reference for? *

How long have you known the candidate? *

Less than a month

1-6 months

7-12 months

1 year or more

Choose the best answer for each of the following. *

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
This candidate will be working with children. In your opinion, is this individual suitable to work with young children?	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Can this candidate can be trusted with confidential information?	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Can this candidate make quick, sound decisions while on the job?	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Can this candidate maintain professional relationships with co-workers and school personnel?	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Can this candidate maintain a positive environment for children?	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree

If yes, please explain *

Is there any reason you would not recommend this candidate to work with children? *

Was this candidate, at any time, employed by you? *

If so, was this candidate reliable and punctual? *

How was their work attitude? *

How was their job performance? *

How was their overall performance? *

Comments

May we contact you for additional information? *

Phone Number *

Last Name *

First Name *

Relationship to Candidate *

Relationship to candidate *

Signature *

clear

Date * +