Applicant Reference Form

Applicant Reference Request Form

Reference in respect of? (name of applicant)(Required)

Role or post applied for:(Required)

Date commenced employment/volunteering with you(Required)

Date ending employment/volunteering with you(Required)

Length of time you have known them:(Required)

Capacity in which employed/known:(Required)

Main duties:(Required)

Attendance record: (Number of days of absence in the last two years (excluding annual leave))(Required)

Please provide reasons for absence:(Required)

Suitability for work with children and young people(Required)

Are you aware of any reason why this person might not be suitable to work with children?(Required)

Are you aware of any previous disciplinary action taken against this person where there were concerns relating to children's safety or protection? If so, please give details(Required)

Are you aware of any current investigations or of any disciplinary sanctions, which remain against this person? This may or may not be related to children's safety and protection. If so, please give details:(Required)

Qualities

Please comment on the applicant’s qualities in relation to the following:

Honesty(Required)

Reliability(Required)

Punctuality(Required)

Ability to work as part of a team(Required)

Ability to prioritise workload(Required)

Where relevant to the role, please comment on the applicant's suitability and overall ability to work with children:(Required)

Would you re-employ?(Required)

Yes

Please add any further information or comments that you feel are relevant to the applicant's proposed new role:

Print Name(Required)

Organisation/Company(Required)

Position(Required)

Phone(Required)

Email(Required)

Company address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Applicant Reference Request Form

Qualities

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