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Reference Check Form for Managers

Employer Resource Guide

Reference Check - Manager Level

Note: please answer all questions and be as detailed as possible in your answers.
Candidate _______________________________ Date __________________
Reference Contact ____________________________ Title __________________
Company ___________________________________ Phone # _______________
What was your relationship with ____________? _______________________________
______________________________________________________________________
When and for how long were you employed at the same facility?
______________________________________________________________________
What was your function and what was _____________’s function?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
What were ________________’s major responsibilities?
1. ____________________________________________________________________
______________________________________________________________________
2. ____________________________________________________________________
______________________________________________________________________
3. ____________________________________________________________________
______________________________________________________________________
What would you say were ________________’s most important contributions (that
impacted the organization)?
1. ____________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2. ____________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
How many direct reports did _________________ have during this time? ___________
______________________________________________________________________
How many indirect reports did ________________ have during this time? ___________

Describe _____________’s:
Communication skills: ____________________________________________________
______________________________________________________________________
______________________________________________________________________
Management skills: ______________________________________________________
______________________________________________________________________
______________________________________________________________________
Leadership skills: ________________________________________________________
______________________________________________________________________
______________________________________________________________________
Work ethic: ____________________________________________________________
______________________________________________________________________
______________________________________________________________________
Ability to adapt to change: ________________________________________________
______________________________________________________________________
______________________________________________________________________
Ability to think strategically: _______________________________________________
______________________________________________________________________
______________________________________________________________________
Spoken commitment vs. actual performance: __________________________________
______________________________________________________________________
______________________________________________________________________
Ability to handle stress/pressure: ___________________________________________
______________________________________________________________________
______________________________________________________________________
Creativity/originating new ideas: ____________________________________________
______________________________________________________________________
______________________________________________________________________
Level of integrity: ________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
How would you say ____________is at:
Policy Formulation: _______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Selling his/her ideas: ______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Leading teams: ___________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Working in a team: ________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Inspiring people: _________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Multi-tasking: ___________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What kind of example did ________________ set for his/her direct reports? __________
_______________________________________________________________________
_______________________________________________________________________
On a scale of 1 to 9, how would you rate ______________’s performance? ___________
_______________________________________________________________________
_______________________________________________________________________
How does ______________ compare to other people in his/her capacity (Rate on a scale
of 1 to 4 – 4 being the best)? ________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What are ________________’s three strengths?
1. _____________________________________________________________________
_____________________________________________________________________
2. _____________________________________________________________________
_____________________________________________________________________
3. _____________________________________________________________________
_____________________________________________________________________
What are ________________’s weaknesses?
1. _____________________________________________________________________
_____________________________________________________________________
2. _____________________________________________________________________
_____________________________________________________________________
3. _____________________________________________________________________
_____________________________________________________________________
Would you hire (re-hire) ____________ if you had the opportunity?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Any last comments that would reflect on ______________, or any thoughts on his/her
abilities.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

 

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