THE UNIVERSITY OF TEXAS AT TYLER
TELEPHONE REFERENCE FORM
Date: _____/_____/_____
Name of person talked to: ______
His/Her position: ______
Company Name and Address: ______
Telephone Number: ______
My name is: ______with UT Tyler
I am calling about ______; Are you acquainted with him/her?
(Applicant’s Name)
He/She states employment with your organization from: ____/____/_____ to ____/____/_____
Are those dates correct? Yes No
What was the nature of his/her work? ______
Was he/she absent from work very often? ______
Is there anything that UT Tyler should know about this person
that would be of benefit to him/her or us?
______
Why did he/she leave your organization? ______
Would you be willing to rehire this person? ______
Did they get along with their associates? ______
What about their morals and honesty? ______
Do you have any general comments about this person? ______
______
______
______
______
Signed: ______
Revised 6/2007