Global Reference Check & Employment Verification Form

Candidate’s Name: Emmanuel Oduka

Position Applied For: Locum Business Development Executive

Referee’s Name: Stephen Clement Ovai

Position Title: Director
Organization’s Name: Brainzo Medical Diagnostic Ltd
Relationship to
Candidate:

1. Verify the identity of the candidate, dates of employment and title(s) held.

2. What was your role in relation to the candidate? How long did you work together?

3. What were the candidate’s key responsibilities?

4. Are you aware if the candidate was ever investigated for any code of conduct or
organizational policy violations (e.g., financial, procurement, harassment, etc.)? [Note, if
reference is not sure or refers you to HR to inquire, please follow the steps in the
‘Employment Verification’ section at the end of this form.]

5. Given the opportunity, would you rehire this person?

6. How would you describe the candidate’s strengths?

7. Which areas can the candidate continue to develop? Any areas of weaknesses?

For Supervisor Roles

1. How would you describe the candidate’s supervision and management skills?

2. How does the candidate handle pressure, complexity and meeting deadlines?

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 Global Reference Check & Employment Verification Form

3. Add locally applicable questions.

*For Leadership, Finance, Procurement, Safeguarding & Sub-Partnership Management Roles

Leadership Roles:While employed with your organization, was the candidate investigated for any
organizational policy violation or financial infraction?

Finance Roles:While employed with your organization, was the candidate disciplined for any
financial infraction, or, have financial infractions been discovered after the employee departed?

Procurement (Supply Chain) Roles:While employed with your organization, was the candidate
investigated for infractions, such as fraud or violating standard operating procedures (SOPs) or
have such infractions been discovered after the employee departed?

Safeguarding Roles:While employed with your organization, did the candidate work with
children/ other vulnerable populations directly? If so, has the employee been the subject of any
investigation related to work with children or other vulnerable populations?

Sub-Partnership Management Roles:While employed with your organization, was the candidate
investigated for infractions related to partner resource management or related to work with
children/ other vulnerable populations (including children, elderly, disabled, minorities, etc.)?

Employment & Eligibility Verification

In cases where further validation of employment is needed (e.g., if reference responses raise
questions, or for additional verification roles listed above), additional Employment Verification
can be added to this process. Employment Verification is conducted by contacting the HR
department of the candidate’s former employer(s), to reconfirm and document the following:
- Dates of employment and titles held

- If the candidate is eligible for rehire (yes or no)

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 Global Reference Check & Employment Verification Form

Referee’s Signature:

____________________________________ Date: ____________________________

FOR IRC INTERNAL USE

Reference reviewed by: -------------------------------------------------- Sign/Date: --------------------------------------

Reference reviewed by: -------------------------------------------------- Sign/Date: ---------------------------------------

Comments:

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