Middlebury College
Telephone Reference Check
Name of applicant:
Company contact:
Person contacted:
(Title)
Telephone No.
Dates of employment:
Title:
How long in that position:
Duties:
COMMENTS
Quality of work:
Quantity of work:
Attendance record:
Punctuality:
Ability to get along w/peers:
Supervision given or received:
Reason for leaving:
Would you rehire: Yes_____ No_____ Explain:
Additional Comments:
Salary:
Checked by: Date: