Please answer the questions below. All fields with an asterisk (*) are required.

<sub>Your First Name:*

Your Last Name:*

City:*

State:*

Zip:*

Phone:*

E-mail:*

First Name of candidate:*

Last Name of candidate:*

Position title:*

Number of children and ages at start:*

All Job responsibilities:*

How long did this position last?*

Why did this position end?*</sub>

Please make comments on candidate's abilities in the following areas:

<sub>Attendance:*

Dependability:*

Communication:*

Job Knowledge:*

Initiative:*

Common Sense?*

Does things without needing to be asked or told?*

Motivated?*

Follows Directions?*

Three words to describe the candidate's personality?*
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2.
3.
What are the candidate's best qualities/strengths in working with children?*
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2.
3.
Do you know of any reason why this person should not be employed in a position of childcare?*

Would you rehire?*

Would you consider the candidate to be Patient?*       YES NO
Why?
Would you consider the candidate to be Energetic?*   YES NO
Why?
Please write a 1 or more paragraph review that will be added to information provided in this form. *</sub>

Once you have completed this form, please give us a call M-F between 1pm-8pm MST at 303-513-7733 to verify your recommendation. We may have additional questions regarding this candidate. If we are not available, please leave a message, and we'll call you back during these hours: M-F 1pm-8pm MST.

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