Work Placement Character Reference Check

Work Placement Character Reference Check
This form can be completed by GOCare's admin staff or by the applicant's referee.
Applicants Name

First NameLast Name
Date

DayMonthYear
Referee's Name
Referee's Mobile
Referee's relationship with applicant on resume
Introduction
(Name of applicant) is being considered for work placement position with GoCare as a Disability Support Worker.
Please note that this reference will be used in the overall evaluation of the applicant and will affect whether they are selected to complete their work placement with us . The information you provide may be given to the candidate if requested, Do I have your permission to proceed?

YesNo
The workplacement position (Applicant Name) has applied for a includes providing a range of supports to people with a disability in their homes and the community.
This could be personal care, supporting a person to go shopping, play a sport or enjoy a meal out.
What is the nature of your relationship with the applicant?
Morals and Values Questions
What can you tell me about the applicant's personality?
What can you tell me about the applicant's work ethic?
What would you say are the applicant's strengths?
What would you say are the applicant's developmental areas e.g. weaknesses?
Job-specific questions
In this role a person will be required to be flexible and adaptable. Do you think the applicant has these skills?
In this role the person could be confronted with things that may cause distress or anxiety, such as attending to medical emergencies. How do you think the applicant would manage?
What values do you think the applicant would bring to this role?
In Closing
Do you have any final comments?
Thank you for taking the time to provide feedback. If you wish to provide any furter information, you can contact us on 5500 1257.
Should be Empty:

Work Placement Character Reference Check

Introduction

Morals and Values Questions

Job-specific questions

In Closing