Character Reference Request
Reference Request For:
*
First Name
Last Name
Your Name
*
First Name
Last Name
How long have you known the applicant?
Please Select
1 year
2 years
3 years
4 years
5 years
6-10 years
10+ years
20+ years
30+ years
In what capacity do you know the applicant?
(e.g. friend, brother, ex-colleague)
On the following scale, please rate the applicant with respect to their:
Rows
Poor
Satisfactory
Good
Exceptional
Honesty
Conduct
Punctuality
Quality of work
Relationships with others
How would you describe the applicant with respect to their:
Personality
Strengths
Suitability to work with children
Potential
Does the applicant have any history of disciplinary action that relates to the safety of children?
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Yes
No
If you selected 'Yes', please provide further details
Are there any reasons or circumstances that would make it undesirable for us to consider this person’s request to work with children?
*
Yes
No
If you selected 'Yes', please provide further details
I declare that to the best of my knowledge the information I have given in this reference is correct and complete
*
I Agree
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