Candidate Personal Reference Questionnaire

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Thank you for taking the time to complete our questionnaire. We rely upon well-informed individuals like you to assist us in the selection of personnel who are qualified for public service and who will maintain high standards of performance in the public safety profession.

Personal Reference

Enter details about the person you a providing a reference for

Candidate Name*

First Last

What is your relationship to the Candidate?*

How long have you known this candidate?*

Years Months

Your Details

What is your name?*

First Last

Phone Number*

Email*

Personal Traits

Please rate the Candidate on the following personal traits that they possess from Poor, Fair, Good, or Excellent. Any rating of Poor or Excellent will require further explanation and/or information.

Dependability*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Keeping Commitments*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Confidence*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Honesty / Integrity / Work Ethic*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Personable*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Ethical*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Common Sense / Judgment*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Compassionate*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Listens to Others*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Decisive*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Self-Motivated*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Resourceful*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Patient*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Handling of Criticism*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Handle Problems / Tasks in Stressful Situations*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Judgement / Decision Making*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

How does the Candidate deal with any changes in their life?*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

How does the Candidate deal with difficult problems or emergencies?*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Communication Skills

Please rate the applicant on their communication skills

Verbal*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Written*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Personal*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Phone*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Relationships/ Interpersonal Skills

Please rate the applicant on their relationships/ interpersonal skills.

Co-workers*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Supervisors*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Public*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Family / Friends*

Excellent

Good

Fair

Poor

Unknown

Additional Information*

You provided a 'fair' response, which indicates 'average' or just 'above average', can you expand your response further?

Diversity / Sensitivity

Display Bias Based On

Race / Ethnicity*

Never

Little

Some

Always

Unknown

Additional Information*

Gender*

Never

Little

Some

Always

Unknown

Additional Information*

Religious Beliefs*

Never

Little

Some

Always

Unknown

Additional Information*

Sexual Orientation*

Never

Little

Some

Always

Unknown

Additional Information*

Age*

Never

Little

Some

Always

Unknown

Additional Information*

General Questions

Please provide further details to any “no” answer

Can the Candidate be assertive and confront a problem when necessary?*

Additional Information*

Do you feel the Candidate will be effective in a job where helping other people is a key responsibility?*

Additional Information*

Can the Candidate function in a team environment?*

Additional Information*

Can the Candidate work with person of a different cultural background or of the opposite sex?*

Additional Information*

Would you trust this Candidate with your own personal safety or that of your family?*

Additional Information*

Would this Candidate be a good fit for a Public Safety position?*

Additional Information*

Do you consider the Candidate to be a person of integrity and/or honest person?*

Additional Information*

Do you have complete trust in this Candidate?*

Additional Information*

General Questions

Please provide further details to any “yes” answer

Are you aware of any current or past alcohol abuse issues with Candidate??*

Additional Information*

Are you aware of any current or past illegal drug use with Candidate?*

Additional Information*

Are you aware of any current or past prescription drug abuse with Candidate?*

Additional Information*

Have you seen the Candidate lose control of their emotions?*

Additional Information*

Have you ever seen or heard of this Candidate doing or saying anything inappropriate?*

Additional Information*

Has the Candidate expressed or displayed any bias or prejudice towards others?*

Additional Information*

Can you think of any reason why this Candidate should not be offered this job?*

Additional Information*

Do you have any information that you would like to discuss directly with the background investigator privately?*

How and when would you like to be contacted?*

How do you know this Candidate?*

Have you known this Candidate to ever serve in the US Military or that of any other country? If yes, please provide known details of service.*

What terms would you use to describe the Candidate to someone else?*

What is the Candidate’s strongest character feature?*

What is the Candidate’s weakest character feature?*

Who do you consider the Candidate’s “Best Friend(s)” to be? Please provide full name and contact information (if you have it).

Full Name

Phone

Please provide at least two additional references who know the Candidate. Please provide full name, telephone, and email address.

Full Name

Phone

Please provide additional information about the Candidate that you feel might be relevant to the background investigation.

The Gumshoe Group!

Candidate Personal Reference Questionnaire

Personal Reference

Your Details

Personal Traits

Communication Skills

Relationships/ Interpersonal Skills

Diversity / Sensitivity

General Questions

General Questions