Reference checking documentation form

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Reference Check Control Form Applicant Name: _____________________________________ Personal references checked: Name: ______________________________ Relationship: _______________________________ Address : ______________________________________________________________________________ Telephone: _____________ Date contacted: _____________ Method of contact: ___________________ Notes:________________________________________________________________________________________ ___________________________________________________________________________________________ Name: ______________________________ Relationship: _______________________________ Address : ______________________________________________________________________________ Telephone: _____________ Date contacted: _____________ Method of contact: ___________________ Notes:________________________________________________________________________________________ ___________________________________________________________________________________________ Name: ______________________________ Relationship: _______________________________ Address : ______________________________________________________________________________ Telephone: _____________ Date contacted: _____________ Method of contact: ___________________ Notes:________________________________________________________________________________________ ___________________________________________________________________________________________ Employment references checked: Name: ______________________________ Employer: ______________________________________ Relationship: ________________________ Dates of employment: _______________Pay: __________________ Address : ______________________________________________________________________________ Telephone: _____________ Date contacted: _____________ Method of contact: ___________________ Would you rehire? ___________ Reason for termination: ___________________________________________ Notes:________________________________________________________________________________________ ___________________________________________________________________________________________ Name: ______________________________ Employer: ______________________________________ Relationship: ________________________ Dates of employment: _______________Pay: __________________ Address : ______________________________________________________________________________ Telephone: _____________ Date contacted: _____________ Method of contact: ___________________ Would you rehire? ___________ Reason for termination: ___________________________________________ Notes:________________________________________________________________________________________ ___________________________________________________________________________________________ Name: ______________________________ Employer: ______________________________________ Relationship: ________________________ Dates of employment: _______________Pay: __________________ Address : ______________________________________________________________________________ Telephone: _____________ Date contacted: _____________ Method of contact: ___________________ Position: _____________________ Would you rehire? ___________ Reason for termination: ___________________________________________ Notes:________________________________________________________________________________________ ___________________________________________________________________________________________ Records checked:  School records (date requested: ____________) Notes: ___________________________________________  Criminal records (date requested: ____________) Notes: ___________________________________________  Driving records (date requested: _____________) Notes: ___________________________________________  Credit records (date requested: ______________) Notes: ___________________________________________

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