Employee Reference Request

This is a reference form and is to be filled out by the employer/supervisor of the candidate in question. Please carefully read, sign and date before submitting this form. We ask this form to be submitted 5 working days from being recieved.

Your Details

Name of person completing this form(Required)

First Last

Your email(Required)

What is your job title?(Required)

What company/organisation do you work for?(Required)

Did you work in a supervisory position to the candidate named? Yes or No?(Required)

Candidate Reference

Candidate Name(Required)

First Last

Place of work(Required)

Job Title(Required)

Start date of employment(Required)

End date of employment(Required)

Reason for candidate leaving (if applicable)

Sickness or absence record (if applicable)

Please rate their reliability (if applicable)

Please rate their professional attitude/standards (if applicable)

Please rate their working ability in line with their responsibilities (if applicable)

Please rate their ability to work as part of a team (if applicable)

Please confirm if the candidate is trained and competent in working with children and young people and meeting their needs? Yes or No?

If applicable, please state if the candidate has any recent or ongoing disciplinary action or referrals:

If you have any further comments, please state below

Sign and Submit

Date of signature(Required)

Signature(Required)