Name of Applicant
Relationship to Applicant
Reference Phone Number
How long have you known the applicant and in what capacity?
What was the applicant's attitude toward his or her peers and supervisor?
In what areas do you think the applicant would excel in this position?
In what areas do you think the applicant would need the most support in this position?
Would the applicant live well in a dormitory setting?
Have you ever witnessed any inappropriate or illegal behavior on the part of the applicant?
What age group do you think would be the best fit for the applicant?
Please select a word of phrase to describe the applicant in the following categories:
Interaction with Peers
Respected and Sought-out
Hates being responsible
Leads when needed
Grabs Control Regardless
Please use the scale below to rate the applicant in the following areas:
Never Seen Better
Flexibility (Adjusting to new conditions or duties)
Personal Integrity (Honesty and good decision making)
Cooperation (Ability to meet new people and make friends)
Quality of work (Accuracy/Thoroughness)
Attitude (Disposition toward hard work and authority)
Dependability (Reliability and task completion)
Appearance (Neatness and Dress)
Perseverance (Ability to last 3 months doing hard work 5-6 days a week)
Creativity (Ability to problem solve or innovate new ideas)
Please choose one of the following regarding the applicant for this job:
Recommend with hesitation
Do not recommend this applicant for this job
Is there any information that would be best communicated over the phone?
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