Reference Request Form If you are human, leave this field blank.Reference Request For: *NameYour Name *Your PositionCompanyRelationship with candidate *Your Phone NumberYour Email Address *Employment DetailsDate Employed FromDate Employed ToLeave blank if still employedCandidates Job TitleReason For LeavingLeave blank if still employedIs the Candidate suitable for re-employment by your organisation?YesNoComments / further information about the candidateGeneral ConductExcellentGoodSatisfactoryPoorTime KeepingExcellentGoodSatisfactoryPoorCommunication SkillsExcellentGoodSatisfactoryPoorRelationship With Customers / ClientsExcellentGoodSatisfactoryPoorRelationship With ColleaguesExcellentGoodSatisfactoryPoorLevel of PerformanceExcellentGoodSatisfactoryPoorIs there any reason to your knowledge why the candidate would not be suitable for working with children *YesNoIf yes, please provide detailsI declare that to the best of my knowledge the information I have given in this reference is correct and complete *I agreeSubmit
