Employee Reference Request

Employee Reference Request
Thank you for taking the time to provide a reference. The information you share will help us better understand the applicant’s suitability for the role they have applied for. Please answer the questions as honestly and thoroughly as you can. Your responses will remain confidential and will only be used as part of the selection process.

If you have any questions or concerns, feel free to contact us before submitting the form.
Reference Request For

First NameLast Name
Your Name

First NameLast Name
Relationship with candidate
Company Name
if applicable
1. Employment Details

if applicable
Date Employed From

DayMonthYear
Date
Date Employed To

DayMonthYear
Date
Candidates Job Title
Reason For Leaving
Re-employ?
Comments/further information
2. Please Comment On The Following
General Conduct
Timekeeping
Communication Skills
Relationship with colleagues
Relationship with others (service users/customers)
Level of performance
Has the candidates honesty and integrity ever been brought into question that you are aware of? (Please comment)
Is there anything you believe we should be aware of regarding their suitability to working in a child and young people environment?
Are you aware of any suspicious proceedings, Policy investigations or disciplinary action?
Additional comments. If you have ticked satisfactory or poor for any of the above please provide us with further explanatory information
I declare that to the best of my knowledge the information I have given in this reference is correct and complete
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Should be Empty:

Employee Reference Request

1. Employment Details

2. Please Comment On The Following