TEMPORARY EMPLOYEE WORK REFERENCE FORM
Temp Name:
Position:
Start Date:
End Date:
Supervisor:
Department:
Please select a rating from the drop down boxes below that best describe the work behavior of the temporary employee listed above.
Please rate each item on the following scale:
1=Excellent 2=Above Average 3=Average 4=Below Average 5=Poor
Attendance
_
1
2
3
4
5
Quality of Work
_
1
2
3
4
5
Quantity of Work
_
1
2
3
4
5
Interacts well with others
_
1
2
3
4
5
Meets requested Skill Levels
_
1
2
3
4
5
Overall Rating
_
1
2
3
4
5
Additional Comments:
Would you request this individual for future temporary assignments?
_
Yes
No
Supervisor's Name:
Supervisor's Title:
Date Completed: