reference Reference Request Applicant First Name Last Name Job Title Name Referee First Name Last Name Job Title Email Company Details Company Name Company Address Start Date End Date Current Status Is the candidate still employed by this company? YesNo Please now rate specific areas of this person's work performance Reliability & Punctuality UnsatisfactorySatisfactoryGoodVery GoodExcellent Honesty & Integrity UnsatisfactorySatisfactoryGoodVery GoodExcellent Standard of Work UnsatisfactorySatisfactoryGoodVery GoodExcellent Ability to work with others UnsatisfactorySatisfactoryGoodVery GoodExcellent Ability to follow instructions UnsatisfactorySatisfactoryGoodVery GoodExcellent Additional Information Is this person part of any current disciplinary procedure or investigation? YesNo Subject to company policy would you re-employ this individual? YesNo Do you know of any reason why this applicant would not be suitable to work or have contact with vulnerable people, including children, within a care organization? YesNo Additional Comments
