Reference Request

Private & Confidential

Employee Name:(Required)

First Last

Date of employment:(Required)

Company name:(Required)

Description of responsibilities:(Required)

Would you recommend for hire?(Required)

I hereby confirm the above reference to be a true and accurate reflection, to the best of my knowledge:

☐ Please tick here if your company policy is to confirm employment dates only

Your name:(Required)

First

Position:(Required)

Signature(Required)

Company name:(Required)

Date:(Required)

Thank you for taking the time to complete this reference.