REFERENCE FORM
Applicant Record
Date of Employment
From:
To:
Post held whilst under your employment:
Reason for leaving:
Would you re-employ this person:
Yes
No
How would you assess the candidate’s performance in relation to the following?
CRITERIA
Unsatisfactory
Satisfactory
Good
Very Good
Honesty/Trustworthiness
Conduct
Time Keeping
Attitude towards work
Ability to work without supervision
Professionalism
Acceptance of responsibility
Verbal communication
Grooming and appearance
Do you know of any reason why we should not employ this person?
Yes
No
(If yes, please give details)
Are there any current disciplinary records?
Yes
No
(If yes, please give details)
Please give an overall view on the candidate’s attributes and abilities:
Subject to the Rehabilitation of Offenders Act (1974) Exemption Order (1957). It is not therefore contrary to the act to reveal information you may posses concerning convictions, which otherwise be regarded as ‘spent’. To the best of your knowledge, are you aware of any criminal convictions?
Yes
No
(If yes, please give details)
Referee's Details
Please take the submission of this reference form as having my signature and the company's seal/stamp.
Submit
Referee
Please take the submission of this reference form as having my signature and the company's seal/stamp.
Submit