Confidential Reference Request

Name for reference *

Position applied for *

Branch *

Section *

The above named candidate has applied to be included on our register of carers and states that he/she was employed by you as stated above. It would be most helpful if you would provide us with a reference for this person. Please could you confirm that the above details of the applicant are correct and, in addition, comment on the following. (In order to protect the public, the post for which this application is being made is exempt from Section 4.2 of the Rehabilitation of Offenders Act 1974 (Exemption Order 1975). It is not therefore in any way contrary to the Act to reveal any information you may have concerning convictions which would otherwise would considered as "spent" in relation to this application and which you consider relevant to the applicant's suitability for employment)

Professional Competency *

Reliability *

TimeKeeping / Attendance *

Honesty *

Attitude *

Flexibility *

Ability to work in a team *

Communication Skills *

Dates employed from dd/mm/yyyy *

Dates employed to dd/mm/yyyy *

In what capacity was the above person known to you? *

Please state *

Would you re-employ this person? *

Yes
No

Why not? *

Are you aware of any impediment that would restrict this person from working with children? *

Yes
No

Please state *

Suitability for Agency work *

Please state *

How many sick days whilst in your employment?

Please put any additional comments you would like to make about this person here:

Has this person ever been involved in any suspensions and/or disciplines? *

Name *

First

Last

Position *

Company *

Email address of referee *

Date *

Sonderwell Life

Sonderflex

Learning and Training Academy

Sonderwell Care

Sonderwell People