Reference Check Form

Your Name

Date

Phone

Email

Name of Person Reference is for(Required)

Relationship to Applicant(Required)

How long have you known the applicant(Required)

Could you give me an example of the applicant’s ability to work with and relate to others?

Can you give me an example of when he/she was able to learn something new and use it in his/her work?(Required)

If yes, can you give me an example of how the applicant relates to and works well with children?

Are you aware of any reason why we should NOT consider this applicant for employment with contact with children?(Required)

Could you give me an example of when you placed trust in him/her?

Why or Why Not?

Any additional comments?