National Rural Support Programme
Reference Check
General Information:
Name of Candidate:-
Contact :-
Position Applied for:
E-Mail:-
Reference Information:
Name:
Contact:-
Title/Position:
Email:
Organization:
Location:
Nature of Relationship with the Candidate
______________________________________________________
Background & Experience:
1.
What position(s) did the candidate hold, during the period in question?
___________________________________________________________
2.
When did the applicant work for your organization/company?
From __________ to __________
3.
What were the candidate’s assigned roles, responsibilities and activities?
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
2
Reasons for leaving your organization/company.
__________________________________________________________________
__________________________________________________________________
Personal Suitability:
1.
Please rate the candidate in the following areas:
Quality of Work
Excellent
Good Satisfactory Poor
Discipline/Attendance
Excellent
Good Satisfactory Poor
Team Interaction
Excellent
Good Satisfactory Poor
Integrity/Honesty
Excellent
Good Satisfactory Poor
2.
YES
Has he/she been subject to any disciplinary action due to sexual harassment or financial
irregularity:
NO
If “YES” Please describe:-
__________________________________________________________________
__________________________________________________________________
Please tick this box if you do not wish to pass this information to the individual concerned
Thank you on behalf of NRSP and the candidate for the time you have taken in completing this.
Signature & Date__________________________