Midwest Twisters & WCGC Employee Reference
Applicants Name
Name of Company
Your name & position at the company?
Where your the applicants supervisor?
Clear selection
Dates employed
Job title
Rate of Pay $
Reason for leaving?
Eligible to be rehired:
Clear selection
Would YOU hire them back:
Clear selection
Attendance:
Clear selection
Work Performance:
Clear selection
Anything else you can tell me about this person?
Can we contact you with Questions?
Clear selection
If Yes, what is the best number to reach you?
Date Completed
MM
/
DD
/
YYYY
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