For Wildlife Research, Education & Conservation
Confidential
REFERENCE CHECK FORM
Please assist us to know more about the candidate by responding to the questions below and please submit
back the full filled and duly signed form to the HR Department of The Jane Goodall Institute Tanzania. We
would like to assure you that your provided reference feedback will be kept confidential and used for hiring
purpose only of the said candidate.
Candidate Name: __________________________________________________________________________
Job Position applied: _______________________________________________________________________
Referee Name: ____________________________________________________________________________
Referee’s Job Position: ______________________________________________________________________
Referee’s Organization: _____________________________________________________________________
Period you have known the candidate:
From (Month, Year) _____________________________ to (Month, Year) _____________________________
Employment relationship with the candidate: ___________________________________________________
(Colleague, Supervisor, Manager, etc)
Please rate the candidate against the listed skills in the table below using the following scale:
1 – Poor, 2 – Satisfactory, 3 – Good, & 4 – Very Good.
S/No. Skill Rating (1 - 4) Comments (If any)
1. Adaptability & Flexibility Skill
2. Communication Skills
3. Taking initiative
4. Quality of work and delivering the
expected performance results
5. Ethics & Integrity Skill
6. Teamwork Skill
7. Planning & Organizing Skills
For Wildlife Research, Education & Conservation
8. Attention to details
9. Positive Attitude
10. Stress Management Skill
11. Decision Making Skill
12. General character of the candidate
(temperament & personality)
Please indicate YES or NO about the candidate to the below four questions:
1. Was the candidate convicted of any misconduct/negligence? YES / NO (If YES please give details)
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2. Can we trust this candidate with confidential information/documents? YES / NO (If YES please give
details)
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3. Would you hire / rehire this candidate? YES / NO (If YES please give details)
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4. Do you recommend the candidate for this position? YES / NO (If YES please give details)
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For Wildlife Research, Education & Conservation
Please write your responses about the candidate to the five questions below:
5. What would be the candidate’s areas for improvement and how would they impact on the
candidate’s ability to perform his/her job? -----------------------------------------------------------------------------
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6. Do you know any health problem the Candidate has which may hinder and interfere with his/her
work performance?------------------------------------------------------------------------------------------------------------
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7. How effectively did the candidate interact with colleagues, subordinates, and leaders? How does
s/he handle difficult people? What is his/her conflict resolution protocol?
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8. What is the candidate’s leadership style and what has been his/her key leadership challenges?
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9. Do you have any further comments or reservations regarding the candidate?
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Signature and Details of the Referee
Referee’s Full Name:
Referee’s Job Position:
For Wildlife Research, Education & Conservation
Referee’s Organization:
Referee’s Signature:
We thank you for taking your quality time to complete this reference check form.
