Employee Reference Question Title * 1. Applicants Details Name of The Applicant Your Company Your Email Address Your Phone Number Question Title * 2. Applicant's Job Title (Current / Latest) Question Title * 3. In what capacity do you know the applicant? Please briefly describe the applicants main duties / responsibilities Question Title * 4. How long have you known the applicant? Less than 6 months More than 6 months Less than 1 year More than 1 year Question Title * 5. Please state the reason for leaving End of contract Unsatisfactory performance Breach of company conduct Self initiation Other (please specify) Question Title * 6. Employee's General Suitability Very Poor Average Good Excellent Punctuality and attendance Punctuality and attendance Very Poor Punctuality and attendance Average Punctuality and attendance Good Punctuality and attendance Excellent Character / conduct / relationship with colleagues and students Character / conduct / relationship with colleagues and students Very Poor Character / conduct / relationship with colleagues and students Average Character / conduct / relationship with colleagues and students Good Character / conduct / relationship with colleagues and students Excellent Overall reliability plus suitability to work with children and young people Overall reliability plus suitability to work with children and young people Very Poor Overall reliability plus suitability to work with children and young people Average Overall reliability plus suitability to work with children and young people Good Overall reliability plus suitability to work with children and young people Excellent Ability to organise / work under pressure Ability to organise / work under pressure Very Poor Ability to organise / work under pressure Average Ability to organise / work under pressure Good Ability to organise / work under pressure Excellent Communication skills Communication skills Very Poor Communication skills Average Communication skills Good Communication skills Excellent Question Title * 7. Are you aware of any criminal convictions of the employee? Yes (If yes please state below) No Other (please specify) DECLARATION: I confirm that the information provided is true and valid to the best of my knowledge and nothing has been concealed therein. Question Title * 8. Your Name Question Title * 9. Position & Date Done