Oglala Lakota County School District
Telephone Reference Check
Name and Title of reference
Is this person the candidate's immediate supervisor?
Yes
No
If not the immediate supervisor, what is the employment relationship?
Company Name
Work Phone:
Please enter a valid phone number.
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Dates of employment:
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Month
-
Day
Year
Date
To
-
Month
-
Day
Year
Date
Date reference initiated
/
Month
/
Day
Year
Date
On a scale of 1-5, 1 being Poor and 5 being Excellent. How would you rate this candidate on the following?
1
2
3
4
5
Attendance
Dependability
Works well with others
Ability to carry out Assigned Tasks
Overall Work Ethics
Were there any issues youare aware of that impacted her/his job performance?
Would you re-employ this person?
Yes
No
What was applicants reason for leaving your company
Do you have any additional comments you would like to share
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