Background Employer Questionnaire
DISCLAIMER:
YOUR RESPONSES WILL BE CONFIDENTIAL IN ACCORDANCE WITH CALIFORNIA EVIDENCE CODE 1040 CALIFORNIA EVIDENCE CODE 1040. (a) As used in this section, "official information" means information acquired in confidence by a public employee in the course of his or her duty and not open, or officially disclosed, to the public prior to the time the claim of privilege is made. (b) A public entity has a privilege to refuse to disclose official information, and to prevent another from disclosing official information, if the privilege is claimed by a person authorized by the public entity to do so and: (1) Disclosure is forbidden by an act of the Congress of the United States or a statute of this state; or (2) Disclosure of the information is against the public interest because there is a necessity for preserving the confidentiality of the information that outweighs the necessity for disclosure in the interest of justice; but no privilege may be claimed under this paragraph if any person authorized to do so has consented that the information be disclosed in the proceeding. In determining whether disclosure of the information is against the public interest, the interest of the public entity as a party in the outcome of the proceeding may not be considered. *****THE INTERNET SITE WILL AUTOMATICALLY TIME-OUT AFTER 60 MINUTES. PLEASE COMPLETE THE QUESTIONNAIRE WITHIN THE ALLOTTED TIME*****
Enter the PIN provided by the Background Investigator
( ) -
Today
Today
What was the applicant's job title and primary responsibilities?
Was the applicant frequently late?:

Excessive absences?:

Did the applicant have Excessive absences?
Were there any issues you are aware of that impacted the applicant's job performance?
Did the applicant get along well with management and co-workers?
Was the applicant ever promoted? If so, how many times and what was the position promoted to?
Did the applicant supervise other people? If so, were they an effective supervisor?
How did the applicant handle conflict, pressure and/or stress?
Did the applicant receive evaluations? If so, what were their strong and weak points and were any deficiencies ever noted?
Rehire the applicant?:

Would you rehire the applicant if the opportunity arose?
Can you describe the applicant's experience working as a team member?
How well did the applicant take direction?
Did the applicant show initiative and/or drive?
Did the applicant ever have any integrity issues? If yes, please explain.
Was the applicant ever disciplined? If so, for what reason?
Is there anything I have not asked that you would like to share?
Final Thought:
If you have any questions, or would prefer to speak to the Background Investigator, please use the contact information contained in the email.
Enter security code:
 Security code