http://www.nyu.edu/hr • empinfo@nyu.edu • tel: 212.998.1250 • fax: 212.995.4229
form: erefchk.pdf • last revised: 04/08/05 • page 1/3
Human Resources Division
Employment Office
7 East 12th Street, 1ST Floor
New York, NY 10003-4475
Reference Check Form
Name of Applicant
Position Applied For
Company Contacted
Contact Name and Title
Telephone Number Working/Reporting Relationship to Candidate
1. What position did applicant hold with
your company?
2. What were the dates of employment?
to
3. What was the final salary?
4. Describe the duties the applicant performed in this position.
5. How would you describe the applicant’s overall performance?
6. Approximately how many times in a 12 month period was the applicant late or absent from work,
excluding FMLA time and any approved time such as vacation and paid sick time?
7. How well did the applicant get along with coworkers (i.e., teamwork)?
http://www.nyu.edu/hr • empinfo@.nyu.edu • tel: 212.998.1250 • fax: 212.995.4393
form: erefchk.pdf • last revised: 04/08/05 • page 2/3
8. How well did the applicant follow direction?
9. How well did the applicant perform assignments?
10. Did the applicant follow-through on assignments in a timely manner? Please describe.
11. How was the applicant’s decision making ability and ability to work independently?
12. Describe applicant’s written and verbal communication skills (i.e., the ability to verbally communicate with
others, type vs. Draft memos or correspondence). (Ask only if relevant to job.)
13. What duties did applicant perform the best?
14. What areas could have been improved?
http://www.nyu.edu/hr • empinfo@.nyu.edu • tel: 212.998.1250 • fax: 212.995.4393
form: erefchk.pdf • last revised: