Former Employer Reference Release Form | McHarrie Life Senior Community

Please complete the following:

Former Employee Name

Former Employee Position(s)

Dates Employed

RATINGS

Quality of Work

Productivity

Cooperation

Ability to Get Along with Others

Attendance

Reason(s) for Termination of Employment:

Would you re-hire this employee?

Yes

No

If no, why?

Additional Comments:

Signature

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What is your title?