Nationwide Placement, Call Us Today
(212) 600.2085

Reference Questionnaire

Reference Questionnaire for Candidate
No candidate record could be found. Please try the URL you were provided again. If you continue to experience trouble, please contact us.
Reference Check
If the position duties included childcare and household upkeep/management, please choose “Nanny/Childcare”

Who is completing this questionnaire?

Who is answering this questionnaire?
Street, City, State Zipcode

We greatly appreciate you taking the necessary time to complete this reference questionnaire, providing the most accurate and honest feedback possible. All responses will remain confidential.

Per agency requirements, can you verify that you are NOT related to the candidate?
Would you feel comfortable recommending this candidate?
Do we have your permission to release your comments to potential employers?

By signing below, you verify that the information provided is true and complete to the best of your knowledge and that your identity matches that of the signature name.

Thank You!
Your feedback is important to us.
We appreciate the time and effort you're taking to complete this questionnaire on behalf of your former hire.
If you have questions regarding this reference form, your personal data related to this questionnaire*, or any other inquiry about our screening process including how to hire for your home with Household Staffing, please contact us at any time.
  • *We do not use information submitted on this questiionnaire for personal contact or marketing purposes. Please see Our Terms & Conditions for more detail.