Applicant’s name

Interviewer’s name
Date

Question Answer Interviewer Notes

Please check the box that apply
Asked me to repeat or rephrase the
Why do you want to work in U.K? question
Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
What would you need in order to enjoy question
your time in the U.K? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Describe your plans for the future. question
What are your goals? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Describe your general health. question
Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Have you ever suffered from or sought question
treatment for depression, alcoholism, Answered with isolated words or small
drug addiction or an eating disorder? phrases
Please explain. Answered in complete sentences
Asked me to repeat or rephrase the
Has anyone in your family suffered question
from depression or alcoholism? Please Answered with isolated words or small
explain. phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Describe any history of Job abuse in any question
company you have previously worked? Answered with isolated words or small
  phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Describe where you were born and question
raised Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Do you have any siblings? If so, how question
old are they? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Describe the relationship you have with question
your siblings. Answered with isolated words or small
phrases
Answered in complete sentences
 Asked me to repeat or rephrase the
How often do you have contact with question
your family members? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Describe your family’s support of your question
decision to work in U.K. GOOD Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
What is your family’s reaction to you question
spending a year away from home? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
How were you disciplined as a child? question
Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
When, where and for how long have you question
spent time away from home? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
When, where and for how long have you question
traveled in English-speaking countries? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Are you willing to be placed with a question
Company that is of a different religion? Answered with isolated words or small
How would you accommodate? phrases
Answered in complete sentences
Asked me to repeat or rephrase the
What is your favorite area of study? question
Why do you like it? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
What did you like about your last Job question
experience? What did you dislike about Answered with isolated words or small
it? phrases
Answered in complete sentences
Asked me to repeat or rephrase the
Where and when did you complete any question
formal English courses? Answered with isolated words or small
phrases
Answered in complete sentences
Asked me to repeat or rephrase the
What volunteer work have you done? - question
Answered with isolated words or small
phrases
Answered in complete sentences
 Asked me to repeat or rephrase
How will you adjust to a new the question
company, country and culture? Answered with isolated words or
small phrases
Answered in complete sentences
Asked me to repeat or rephrase
How much notice do you require the question
before leaving for a placement Answered with isolated words or
with your company? small phrases
Answered in complete sentences
Asked me to repeat or rephrase
the question
Answered with isolated words or
small phrases
Answered in complete sentences
- Asked me to repeat or rephrase
What problems do you anticipate the question
while working in your previous Answered with isolated words or
job? small phrases
Answered in complete sentences
Asked me to repeat or rephrase
How do you feel about being the question
placed with a Company of a Answered with isolated words or
different race or has different small phrases
political views or beliefs? Answered in complete sentences

The remaining questions are to be completed by the

interviewer

Poor Fair Good Excellent

Appearance Excellent
Please rate the Job Seekers:
Self Confidence Excellent

Attitude Good

Manners Excellent

Communication skills Good

English Rating Scale

1 – Uses few or no English words; understands greetings and other basic, memorized phrases.

2 – Uses some English phrases though thoughts may be disconnected; understands basic English sentences when spoken clearly
and slowly but relies on body language and facial expressions to determine meaning.

3 – Responds in complete thoughts and has a large vocabulary of everyday common terms. Can perform tasks based on a short
series of instructions, takes short time to mentally translate and can understand complex sentences when repeated or rephrased.

4 – Responds in complete sentences and can re-word what he/she is saying when the meaning is unclear or when he/she cannot
remember unusual vocabulary words. Can perform tasks based on complex instructions and understands others when they are
speaking at a natural rate.

5 – Responds completely with more descriptive language and does not take time to mentally translate when listening or
speaking. Understands conversations about abstract things.
 Based on the table above, please rate the applicant’s ability Rating: Native
both to speak and comprehend English. Briefly explain your
decision. Explanation:

This applicant will make a good staff workers for the

following reasons:

What difficulties will the applicant experience while placed

working in a foreign country?

Interviewer’s signature

Date

Contract Period of 2 years and can be extended on satisfactory basis with a 2 month onshore and offshore contract

Benefits included will be accommodation, flight tickets, feeding and all other incentives