Request for Reference

REQUEST FOR REFERENCE

Date:____________________________

To:______________________________




Re:______________________________


The above-named individual has applied for a position with our company and indicates previous employment with your firm. The information requested below will help us to evaluate the applicant. We will hold your comments in strict confidence. Thank you for your cooperation.

Sincerely,

Personnel Department


Please Indicate:

Position With Your Firm:____________________________________________________

Employed From_______________________________Through_________________________

Final Salary $_____________________Social Security Number___________________

Please rate the applicant on the basis of his employment with you (good/fair/poor):

Ability__________________Conduct___________________Attitude_________________

Efficiency_______________Attendance________________Punctuality______________

What was the reason for termination?________________________________________

____________________________________________________________________________

Would you re-hire?___________________. If not, give reason:________________

____________________________________________________________________________
 

____________________________________
Signature and Title