Reference Request
Thanks so much for your time! This form should only take a few minutes.
Your name
*
Applicant's name
*
Name of your organisation
*
Location of organisation
*
Your position within the organisation
*
Applicant's position within the organisation
*
Dates applicant worked at the organisation
*
Applicants reason for leaving
*
Applicants hourly wage
Has the Applicant been the subject of disciplinary proceedings (whether formal or informal) during their employment? If so, please provide details of the allegations against the Applicant and the outcome of the proceedings
*
With reference to the job description, are you satisfied that the Applicant has the ability and is suitable and safe to undertake this role? Please give any details of specific strengths or weaknesses
*
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Please score the applicants competency / character level
on a scale of from 1 star (lowest) to 5 star (highest):
Reliability and punctuality
*
1
2
3
4
5
Communication and teamwork
*
1
2
3
4
5
Showing initiative
*
1
2
3
4
5
Resilience
*
1
2
3
4
5
Sense of humour
*
1
2
3
4
5
Following policy
*
1
2
3
4
5
Completing paperwork
*
1
2
3
4
5
Managing groups
*
1
2
3
4
5
Hero potential
*
1
2
3
4
5
Understanding Safeguarding and Child Protection
1
2
3
4
5
Skip if they didn't work with children
Understanding of the EYFS
1
2
3
4
5
Skip if they didn't work with children
Would you be willing to re-employ the Applicant? If your answer is “No”, please explain why.
*
Any closing remarks
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