KES Employment or Professional Reference ... - Kelly Services



EMPLOYMENT OR PROFESSIONAL REFERENCE VERIFICATION

The candidate named below applied for a position with Kelly Educational Staffing and provided your name as a reference. We appreciate your assistance with verifying the information provided and assessing their qualifications.. Thank you.

|Candidate Information |

|Candidate Name:       |Employment Dates:       /       -       /       |

|Position/Job Title:       |Salary/Pay Rate: $       Per       |

|Job Responsibilities:       |

|Reference Information (Please enter the following information for the person completing this verification.) |

|Name:       |Title:       |Telephone No.:       |

|How are you acquainted with the candidate named above? Supervisory role Co-worker Other:       |

|Signature: Date: |

|Reference Questions |

|How are you acquainted with the candidate? |

|Supervisory role (Verify dates of candidate’s previous employment.) |

|Coworker |

|Other (e.g., minister, doctor, teacher, lawyer) |

|Note: Friends are not acceptable references. The candidate must have worked with the reference or must know the reference on a professional basis. |

|When did you work with the candidate?       |

|What were the candidate’s main job duties and responsibilities?       |

|Why did the candidate leave your organization?       |

|Were there any attendance problems? Yes No |

|If Yes, please explain:       |

|Reference Questions (cont’d.) |

|Have you had the chance to watch the candidate interact with children? Yes No |

|If Yes, were the interactions positive? Yes No |

|Why or why not?       |

|Do you believe the candidate would be suitable to work at a school, in direct contact with children? |

|Yes No |

|Why or why not?       |

|Would you have any reservations about the candidate in such a position? Yes No |

|If Yes, please explain:       |

|What other comments would you like to add regarding the candidate?       |

|Performance Assessment (On a scale of 1 to 5, please rate the following aspects of the candidate’s performance.) |

|1 - Poor 2 - Below Average 3 - Average 4 - Above Average 5 - Excellent N/A - Not applicable |

|Task |1 |2 |3 |4 |5 |N/A |

|Acted as an effective role model | | | | | | |

|Communicated verbally | | | | | | |

|Exhibited high expectations for self and others | | | | | | |

|Maintained accurate records | | | | | | |

|Solved problems | | | | | | |

|Worked with other staff | | | | | | |

|Worked with supervisors | | | | | | |

|Communicated with parents | | | | | | |

|Controlled and maintained discipline in a classroom | | | | | | |

|Got involved in extra-curricular activities | | | | | | |

|Used multiple teaching strategies | | | | | | |

|Worked with children | | | | | | |

|Overall rating of the candidate | | | | | | |

|If you could rehire this person, would you do so? Yes With Reservation No |

|If No or With Reservation, please explain:       |

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