INTERVIEW ASSESSMENT FORM
Applicant Name: Date:
Position Applied: Source:
Initial Interviewer's Assessment
Assess the applicant based on factual data gathered in this verification. Read each category and write the actual rating.
1 2 3 Rating Justification
Not Related to job Not related but with Related to the job
Educational Background requirement equivalent work requrement
experience
Transient No permanent
Residence address
Rented/Boarding Owned
More than One(1) hour More than Thirty(30) Less than Thirty(30) minutes
Proximity to Workplace travel minutes travel travel
More than Three (3)
Dependents Dependents and no other With 2 dependents 1 or No dependents
source of support
Over age for the job Relatively younger or
Age requirement
older for the job Within the job requirement
requirement
With visible tatoos/excess
Average for the job
Physical Apperance body percing or signs of
requirement
Fit for the job requirement
unneccessary behavior
With health condition that With minor health
Health Condition requires medical corrections like Physically Fit
attention/maintenance vision etc.
Drink/Smoke
Drink/smoke frequently ave Occassionaly ave
consumption of more than 3 consumption of 3
Lifestyle bottles & more than 3 sticks bottles less than 3 Doesn't Drink/Smoke
of cigarrette in a day sticks of cigarette in
aday
Average work
No significant work Highly Recommended work
Work experience experience
experience but
experience
highly trainable
Recent Salary:
Negotiable within
Compensation Package Out of salary expectation the budget Within the budget
2 to 2.5 Medium
Assessment: 1-1.99 High Risk
Risk
2.6 to 3 Low Risk Ave Rating
Work Experience Special Achievement Reason for Leaving Salary Expectations
CURRENT SALARY
Current Job
Previous Job 1 Allowance : _______________________
Others : _______________________
Previous Job 2
EXPECTED SALARY
Previous Job 3
Basic Salary : _______________________
Previous Job 4
Others : _______________________
Previous Job 5
Interviews Narrative: (Updated resume must be attached)
Initial Interviewer's summary of assessment: Negtotiable Salary:
___________________________________
Initial Interviewer's Recommendation:
Not Recommended
Initial Interviewer: For Active Pooling
For Final Interview
Final Interviewer's Assessment: Final Interviewer's Recommendation:
Recommended for Hiring
For Active Pooling
Final Interviewer:
Not recommended for hiring