Midwest Twisters & WCGC Employee Reference
Applicants Name
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Name of Company
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Your name & position at the company?
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Where your the applicants supervisor?
Yes
No
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Dates employed
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Job title
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Rate of Pay $
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Reason for leaving?
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Eligible to be rehired:
Yes
No
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Would YOU hire them back:
Yes
No
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Attendance:
Great
Good
Fair
Poor
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Work Performance:
Great
Good
Fair
Poor
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Anything else you can tell me about this person?
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Can we contact you with Questions?
Yes
No
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If Yes, what is the best number to reach you?
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Date Completed
MM
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DD
/
YYYY
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