Reference Check Form
(all information will remain confidential)
Applicants Name:
*
1. How long have you known the applicant?
*
2. What is your relationship to the applicant? (relative, friend, employer)
*
3. Based in what you know about the applicant, why do you think she or he is interested in home sharing right now?
*
4. Please share with us your impressions of this person (we are looking for things such as honesty, housekeeping skills, dependability, ability to compromise, prompt bill payment and personal habits).
*
5. If you were interested in sharing a home, would you consider this applicant for a housemate? Please tell us why or why not?
*
6. To your knowledge, has the applicant ever had any trouble with the legal authorities? Drug or alcohol abuse problems? Emotional or psychological problems?
*
7. Do you have any concerns or reservations about this person sharing a home with another?
*
8. Additional Comments:
Name of Reference
*
Phone:
*
Format: (000) 000-0000.
Email:
*
example@example.com
Mailing Address:
*
Date:
*
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Month
-
Day
Year
Submit
Should be Empty: