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Personal Reference
Applicant's Name
*
Person Giving Reference
*
Contact Number
*
How long have you known the applicant?
*
Relationship to the Applicant
*
Is there any reason we might not want this person to work with either money or a vulnerable population? Why?
*
Have you ever worked on a project with this individual?
*
Have you ever worked on a project with this individual?
A
Yes
B
N
Did the applicant
follow through with his/her portion of the duties or responsibilities and rate the quality of work the applicant did?
*
Is this Person...
Reliable
*
Reliable
A
Yes
B
No
Patient
*
Patient
A
Yes
B
No
Compassionate
*
Compassionate
A
Yes
B
No
I would best describe this individual as
*
This person’s strengths include
*
This person could be more effective if he/she worked to improve
*
Is there anything else you might be able to tell us about his individual that would help us to
make an employment decision?
*
Submit