ATLANTA POLICE DEPARTMENT

Employee Referral Form

Applicant: (Please print)	For:
Police Officer
Other
Referral employee: (Please print)	APD ID no.
1.	Are you related to the applicant?	Yes	No	If yes, what is the nature of the relationship?
2.	How long have you known the applicant?	Years	Months	Days
3.	Please rate the applicant to the best of your knowledge on the factors indicated below:
Overall Evaluation:	Excellent	Good	Average	Questionable	Unknown
Family Background:	Excellent	Good	Average	Questionable	Unknown
Ability to handle stress:	Excellent	Good	Average	Questionable	Unknown
Temperament:
Maintains

control of

temper
Loses temper

sometimes
Loses temper

easily
Unknown
Willingness to

serve others
Helpful
Helpful

sometimes
Helpful

when asked
Never does

anything to

to help
Unknown
Personality:
Outgoing/

friendly
Shy/Reserved
Outspoken
Quiet
Open-minded
Narrow-minded
Argues a lot
Argues

sometimes
Never argues
Other
Alcohol/Drugs
Drinks to

excess
Drinks

moderately
Does not drink
Unknown
Uses drugs regularly
Uses drugs sometimes
Does not use drugs
Unknown
Meets and converses with new acquaintances
Easily
With difficulty
Unknown
Would recommend

Applicant for position
Yes
No
Not sure
4.	How do you know the applicant?
5.	If you would like to provide additional information or comments about the applicant, please do so in the space provided below.
Use the back of this page if additional space is needed.
This form completed by:	Sign:
Date:
Print
Background Investigator:	Notary:

Form APD 267 10/18/06

ATLANTA POLICE DEPARTMENT

VLivsey

2008-06-20

Atlanta Police Department