WTCP Reference 1
wtcpstaffing.com
Applicant Name
*
First Name
Last Name
Reference Name
*
First Name
Last Name
Reference Title
*
Reference Company
*
Reference Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference Email
*
example@example.com
Facility Worked With Applicant:
Applicant Title at Facility
Employment Start Month/Year & End Month/Year:
Reference Checked by:
What is your business relationship with the applicant?
Did you directly supervise the applicant?
What level of supervision did the applicant need?
How long have you known the applicant?
Describe the applicant’s duties/responsibilities when you worked together?
What was the applicant’s greatest strength?
Grade the following on a 1-5 scale; 5 being the best:
Duties Completed Satisfactorily?
1
2
3
4
5
Communication?
1
2
3
4
5
Work Habits?
1
2
3
4
5
Dependability?
1
2
3
4
5
Trustworthiness?
1
2
3
4
5
Initiative?
1
2
3
4
5
Punctuality and Attendance?
1
2
3
4
5
Time Management?
1
2
3
4
5
Organization?
1
2
3
4
5
Adaptability to Change?
1
2
3
4
5
Written Skills?
1
2
3
4
5
Work Quality and Productivity?
1
2
3
4
5
Would you rehire this person?
Yes
No
In what areas did the applicant need improvement or could improve on?
Is there anything else we should consider before we hire this applicant?
Submit
Should be Empty: