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Reference Check Form

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10 views

Reference Check Form

Uploaded by

asadimohammedsameer
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Humanitarian Assistance and Development Association for Afghanistan (HADAAF)

Human Resource Department

Reference Check Request Form

 About the Candidate:

Applicant’s Name:
Position to be hired for:

 About the referee:

Name:
Title:
Organization:
Relationship with the
applicant:

1. Please describe the key responsibilities the candidate held in their role/roles;
including their major achievements

2. Please provide us with up to key strengths and areas of improvements for the
candidate.

3. How do you describe the candidate’s character and attitude?

4. Please give details of any formal disciplinary action during employment:

5. Please provide us with the reason for the applicant's leaving your organization.

6. Were there any professional causes for concern during the applicant’s
employment / any investigations in process that haven’t been closed out?
7. Would this individual be eligible for rehire by your company? Why or why not

8. What is your overall assessment of the candidate?

 Child safeguarding:

9. As an organization committed to the welfare of children, we need to know if you


have any information or knowledge of this applicant that would cause us any
concerns in relation to the protection of children from abuse or harm: Yes
No

If ‘yes’ please provide further


details:

 PSEA:

10. Was the candidate found1 to have committed misconduct (sexual exploitation,
sexual abuse, or sexual harassment) during the period of employment defined
above?

No
Yes and the nature of the misconduct is:

I am unable to specify the nature of the misconduct because of the following


legal/regulatory
requirements:

11. If the answer above was yes, was a disciplinary measure imposed on the

candidate2:

1
“Found” for these purposes, shall mean that in accordance with the Organizations own relevant internal processes and standards,
Misconduct has been determined to have occurred.
2
Organisations must at a minimum disclose information where a Candidate was dismissed for Misconduct. Organisations may, in their
discretion, disclose the fact of lesser Disciplinary Measures such as suspension and warning. Organizations are encouraged only to include
warnings within the Statement of Conduct where they have been issued within the last two years of the Candidates employment or
position with the organization. Organizations are not expected to disclose Disciplinary Measures which are considered “spent” or
“expunged” according to applicable law or policy.
No, for the following reasons:
Yes, the disciplinary measure was (and the date):
I cannot provide an answer for the following reasons:

Based one the above answer, please write the reasons/ comments here:

12. Is the candidate currently being investigated for an allegation of sexual

exploitation, sexual abuse, or sexual harassment3? (Please circle)

Yes
No
I am unable to provide an answer

I confirm that the information provided above is true, accurate, and complete to the best

of my knowledge and experience with the applicant

Full Name:
Signature:
Date:

 HR confirmation for the Referee:


We hereby certify that Mr./Miss (xxxxxx) holding position of xxxxxx is our employee in xxxxxx

Department.

Name of HR Official ________________________________________

Position__________________________________________________

Signature/Stamp: __________________________________________

3
This question is optional; it is within each Participation Organizations discretion whether to include it.

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