Name
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First Name
Last Name
Email
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Name of Candidate
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Phone
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(###)
###
####
What was your professional relationship to the candidate?
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How long have you known the candidate?
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What job did the candidate perform and what was their responsibilities?
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What were the candidate’s strong points?
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What were the candidate’s weaknesses?
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How did the candidate react to pressure and/or deadlines?
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How did the candidate get along with peers, supervisors and colleagues. Overall, how do you rate his/her interpersonal skills on a scale of 1-5 (5 being highest)?
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1
2
3
4
5
What areas of improvement would you say should be addressed in the candidate’s next position?
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If the appropriate position were available within your organization, would you rehire the candidate? If not, why not?
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On a scale, how you rate them on the following: Has emotional intelligence skills
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Has a good work ethic
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Takes Initiative
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Is punctual and has regular attendance
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Has excellent communication skills
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Has excellent customer service, i.e., working with clients
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Has leadership skills
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Has excellent professional skills, i.e., time management, organization, etc.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Has conflict resolution skills, i.e., ability to manage difficulties as they arose
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
On a scale, how you rate them on the following: Excelled in their performance duties related to the specific employment
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Did they require a lot of supervision or worked well independently?
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Is there any other information you would like to add or any pertinent issues regarding the candidate’s performance that we have not covered?
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