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
Unable to answer

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Would YOU hire them back:

Yes
No
Unable to answer

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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