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Guidance Care

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01253 530008

Guidance Care

Home
Online Forms
Staff Only
Contact Us
01253 530008

Reference Request Form

Reference Request Form

We are seeking a reference in respect of the applicant, who has given his/her consent for us to approach you for this purpose. We would therefore be grateful if you would answer the following questions as fully as possible

Applicants Full Name:(Required)

Name of applicant on the email you received from Guidance Care

Your Full Name:(Required)

Your Phone Number:(Required)

Your Email:(Required)

Your organisation:(Required)

Your job title:

Applicants role within your organisation:(Required)

Their Start Date Of Employment(Required)

DD slash MM slash YYYY

Their End Date Of Employment(Required)

DD slash MM slash YYYY

In what capacity have you known the applicant?(Required)

For how long have you known the applicant?(Required)

During their employment, were there any concerns with sickness and absence?(Required)

Please explain any concerns

During employment, was applicant the subject of a Disciplinary procedure?(Required)

Please explain any concerns

Reason the applicant left employment with your organisation? (If known)

Are you completely satisfied that this candidate is suitable to work with young people?(Required)

Please explain any concerns(Required)

Are you happy that the candidate would meet the requirements within the person specification and job description?

Please find the attached documents as reference for suitability to the role

Attendance(Required)

Excellent

Good

Average

Poor

Punctuality(Required)

Excellent

Good

Average

Poor

Quality Of Work(Required)

Excellent

Good

Average

Poor

Attitude(Required)

Excellent

Good

Average

Poor

Relationship With Colleagues(Required)

Excellent

Good

Average

Poor

Relationship With Service Users(Required)

Excellent

Good

Average

Poor

Honesty and Integrity(Required)

Excellent

Good

Average

Poor

Flexibility and Reliability(Required)

Excellent

Good

Average

Poor

Ability to work without supervision(Required)

Excellent

Good

Average

Poor

Signature(Required)

I confirm that this form is completed accurately to the best of my knowledge

Thank you.

We appreciate you taking the time to complete this reference request. As part of Safer Recruitment guidelines, we will call you to verify this reference.

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