QUESTIONNAIRES 
Please return to 
Your answer to each question may be indicated by a cross (X) placed in the 
appropriate brackets. 
I. Mr....: EE trae ee asuseseayrsx States that he was 
BO VOUT CIMPIOY G8... vss iaivivisii ns aa xt as 5 ses ws vinnie wuld Er 
a te tesiaiy sn a DOB EOE oss uiinnslss 1OB ils 
Does this correspond to your record? Yes ( ) No ¢) 
2. He states that he 1eft DECAUSE. .. ov .vreeerrrennres os, lL II— 
Is this an adequate statement? Yes ( ) No £:). 
3. He stated that he received (in salary or commissions). ...........ousenn.... 
Is this correct? Yes ( ) No ( ). 
If not correct, how much did he receive?. . . . > o's 
4. Were you personally acquainted with him and his work? Yes $Y Nol.) 
5. Was he alwavs honest in financial dealings? Yes ') No ). 
Very Very 
Good Good Average Poor Poor 
6. How do you rate 
hisindustryd. Ll sali) £1) {) €:) £2) 
7. How do you rate his 
personal habits and 
condtct?. eu Y $Y iY {. )  ) 
8. How do you rate his fitness 
for a selling position with 
our organization?..........( )  ) £5) $i) :') 
9. Would you be willing to reemploy him? Ves £."') Nol). 
Signature........ ~ FTTETIR 
We shall appreciate any additional information that may assist us to judge 
the applicant’s fitness for the position. The reverse page is left blank for your 
statement of such information. 
Figure 18: Report form to accompany letter to references. 
ISI