Marquette County
Medical Care Facility
(906) 485-1061
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Personal Reference
This Personal Reference online form is intended to be utilized only by authorized parties. If you did not receive an invite or do not have explicit consent from the Applicant, please refrain from using this form and contact us immediately.
Applicant Name
*
First
Last
Reference Name
*
First
Last
Reference Email
*
Reference Phone
*
Applicant’s Employment Dates
Applicant’s Position Held
How long have you known the applicant?
*
What are the applicant’s strengths and weaknesses?
*
Work Performance
*
very good
good
average
fair
poor
Dependability
*
very good
good
average
fair
poor
Attendance
*
very good
good
average
fair
poor
Honesty
*
very good
good
average
fair
poor
Follows Instructions
*
very good
good
average
fair
poor
Is the applicant eligible for re-employment?
yes
no
Additional Comments
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Email
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Marquette County Medical Care Facility