This form is intended to be sent from one business to another to confirm an applicant's stated dates of employment, salary, and other details.
123 Main St.
Anytown, CA 95928
August 14, 2010
An individual by the name of ____________________ has applied for a position with our company, as has listed your firm as a previous place of employment. We would greatly appreciate it if you could provide the following information to assist us as we considering hiring this candidate. All comments will be held in the strictest confidence.
Position held: _________________
Dates of employment: _________ to __________
Starting salary or hourly rate: ________ Ending: ________
Please rate the employee on a scale of 1 to 5, with 5 being the best, in the following categories:
Skill level: _____
Why is he/she no longer with the firm? ______________________________________
Would you hire him/her again? Why/why not? ________________________________
Jack Jackson, human resources director