Reference Thank you for providing feedback as part of our candidate evaluation process. Applicant InfoApplicant's Name* First Last Your InfoYour Name* First Last Your Email* Your Phone*Your Job Title and/or Relationship to the Applicant Applicant Employment InfoTo the best of your recollection, what were the dates of the applicant's employment?Begin Date (Month/Year)* End Date (Month/Year)* Please note if applicant is currently employed.Job Title* He/she performed the following duties while employed... Vendor/Contract Management Travel Planning Event Coordination Scheduling/Calendar Management Shopping/Errands Other DutiesFrom your experience with the applicant, please rate the applicant in the following areas:And per our agency requirements, we need to verify that you are not related to her/him? Trustworthy*10987654321If 6 or below, please explain. Proactive/Shows Initiative*10987654321If 6 or below, please explain. Professionalism*10987654321If 6 or below, please explain. Judgment/Common Sense*10987654321If 6 or below, please explain. Communication Skills*10987654321If 6 or below, please explain. Attention to Detail*10987654321If 6 or below, please explain. Dependable/Punctual*10987654321If 6 or below, please explain. Flexible/Cooperative/Takes Direction Well*10987654321If 6 or below, please explain. Energy/Stamina in the Position*10987654321If 6 or below, please explain. Delegating Tasks*10987654321If 6 or below, please explain. Hands-on Work*10987654321If 6 or below, please explain. What is the square footage of the home(s)? (if applicable) How many hours per week did he/she work for you? Please describe the applicant’s strengths:*Are there any areas that might need improvement?*Why did the employment end?* Please note if applicant is still employed.Can you recommend this applicant without any reservation for this type of work?* Yes No If no, why?Do we have your permission to release this reference to potential household employers?* Yes - Share for Employment Reasons Yes - Share without my Personal Information Do not share (may preclude them from getting a job) Do future employers have permission to contact you in reference to applicant?* Yes No
