Prestigious Investigative Services

AN EQUAL EMPLOYMENT OPPORTUNITY – AFFIRMATIVE ACTION EMPLOYER

The employer is dedicated to the goal of equal employment opportunity based on merit system principles, free of discrimination or harassment on the basis of race, color, national origin, ancestry, religion/creed, sex, disability, age, medical conditions (cancer), marital status, sexual orientation, retaliation for filing a claim of discrimination, or being afflicted or perceived as afflicted with Acquired Immune Deficiency Syndrome (AIDS) or the Human Immunovirus (HIV)

1-Name of Candidate: *

2-Position Applied for: *

3-Name of reference completing form? *

4-What is your relationship to the candidate? *

5-Have you employed or worked with the candidate? *

6-How long have you known the candidate? *

7-How long since you last had contact with the candidate (i.e., in-person, social media, text, etc.)? *

8-How does the candidate get along with friends, neighbors, fellow workers? *

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9-How would you describe the candidate's friends and associates? *

10-Are you convinced the candidate is honest? *

11-Is candidate reliable? *

12-Would you trust candidate with confidential matters? *

13-To your knowledge, has candidate been involved in any illegal or questionable conduct? *

Illegal or questionable conduct explained. *

14-Has the candidate ever used words, told jokes, or committed any act that could be viewed as insensitive to people based on their race, gender, gender identity, religion, sexual orientation, immigrant status, nationality, ethnicity, disability, or HIV/AIDS infection including within the candidate's own group? *

15-Do you know or suspect the candidate belongs to any subversive or illegal organization? *

16-Describe the candidate’s use of intoxicating beverages: *

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17-Have you observed or do you have knowledge of the candidate’s use of illegal or non-prescription drugs or narcotics, including marijuana (includes any other substance used to obtain a "high")? *

Explain extent of usage. *

18-Describe the candidate’s financial reliability: *

19-Does candidate lose his/her temper easily? *

Does candidate lose his/her temper easily explained *

20-Is the candidate able to make decisions under stress? *

Please give an example. *

21-Do you know anything else about the candidate, which should be investigated before appointment to this position? (Consider things as maturity, loyalty, common sense, judgment, tolerance, ability to recognize own limitations, etc.) *

Please explain *

Are you able to list another person who may be able to furnish information about the applicant: *

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

22-Would you want the candidate to be working in the position they are applying for in the city in which you live and to be responsible for the safety of you and your family? *

Please explain *

23-Do you have any other comments? *

Please comment *

24-Name of Company/Military Branch you worked with candidate? *

25-Between what dates did candidate work for or with you? *

26-Describe candidate's position and duties: *

27-How did candidate react to company policy and procedures? *

28-Please check any problems affecting the candidate's work:

Please explain *

29-How would you rate candidate's job performance? *

Please explain *

30-Why did the candidate leave this job? *

31-Would you rehire the candidate? *

Why not? *

candidate’s former employees (if known): *

Today's Date * +

Type your Full Name/Job Title *

Please Supply your work and Home phone numbers: *

Signature *

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