Employer Reference Form - Everett (Snohomish County) Your Information Today's Date Your Name (First, Last) Your Email Your Phone No Your Company Name Your Company Address Applicant Information Applicant Name (First, MI, Last) Employment Dates From Employment Dates To Applicant Job Title Applicant Salary Starting $ Applicant Salary Ending $ Applicant's job title on the last day of employment? Applicant's overall performance? Outstanding Above Average Average Poor What are the applicant's strong points? What are the applicant's weak points? Applicant's reason(s) for leaving? Your recommendation Hire Do not hire Your Signature Clear Today's Date * Submit