Government Officer Background Assessment Form
Use this form to assess a government officer’s background, experience, integrity review, and overall suitability for role evaluation.
Candidate Background
Candidate Full Name
*
First Name
Middle Name
Last Name
Current Role / Position
*
Employing Agency / Department
*
Years in Government Service
*
Employment And Integrity Review
Current Employment Status
*
Active
On Leave
Former Government Officer
Contractor
Other
Prior Postings / Assignments
Relevant Disciplinary History
*
No
Yes
Prefer to Disclose in Writing
Disciplinary History Explanation
Background Assessment
Overall Background Rating
*
1
2
3
4
5
Assessment Criteria
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Professionalism
1
2
3
4
5
Public Trust
6
7
8
9
10
Ethical Judgment
11
12
13
14
15
Confidentiality
16
17
18
19
20
Reliability
21
22
23
24
25
Assessor Notes
Submit
Should be Empty: