REFERENCE CHECK FORM

(With previous employer)

Date:

Reference Person: Company:

Contact Number: Position:

Applicant Name: JPHIL Position Applied for:

Latest Employer: Employer Contact No.:
Position Last Held: Duration of Employment:
Last Compensation:
Reason for Leaving:
- FEEDBACK ON EMPLOYEE -
1. How long have you known/ supervised the candidate?

2. Please confirm main job responsibilities?

3. How would you describe his / her Excellent Very Good Satisfactory Needs Remarks
Improvement
a. Sense of accountability

b. Integrity

c. Cooperativeness

d. How well did he get along with:

1- Management

2- Co-workers/Peers

3- Clients/Customers

4- Subordinates (if any)

e. Adaptability

f. Communication

g. Job performance/Quality of
Work
g. Planning

h. Coaching

Form No. F-0348-008 <2>

 i. Delegation

j. Decision Making

4. Was there any record of significant company violations during his/her employment? If yes, please specify nature
of offense and disciplinary action given.

5. Was there any record of significant medical examination findings or severe illness during his/her stays in your
company? If yes, please specify findings/illness.

6. Was there any issue concerning money matters or incidence of conflict of interest arising to personal gains in the
performance of his/her job?

7. Should the employee re-apply in your company what will be your recommendation:
Please check answer below.

Highly recommended for hiring

Recommended for hiring with reservations. Please state reason_ _______________________

Not recommended, state reason

THANK YOU VERY MUCH FOR YOUR TIME

Date Accomplished:
Send accomplished form to : HRD Group Manager /Recruitment Officer– Recruitment & Training
E-mail address : hrd@jgc.com.ph
Tel. Nos. (+632) 876-6000

Prepared by: Noted by:

Recruitment Staff HRD Officer HRD Group Manager

Form No. F-0348-008 <2>