Reference Request - JW Care Group

Name of Applicant*

Position Applied For*

How do you know the applicant?*

How long have you known the applicant?*

Are you prepared to provide a reference for this applicant?*

Yes
No

Please provide further information as to why you're unable to provide a reference.*

Have you previously employed the applicant or been their supervisor?*

Yes
No

Your Name*

Your Email

Your Phone

Employer/Company name*

Your Position*

In what capacity was the applicant employed by you?*

Date employed from*

Date employed to*

What was their reason for leaving?*

How do you know the applicant?*

How many un-authorised absences has the applicant had within the last 2 years?

Would you re-employ the applicant?*

Yes
No

Please provide further information as to why you would not re-employ the applicant.*

How long have you known the applicant?*

Please rate the applicant on the following qualities, where 5 stars is Excellent, and 1 star is Terrible.

Quality of work performed

Attendance/Punctuality

Reliability/Trustworthiness

Ability to work within a team

Ability to work under pressure

Ability to work without supervision

Communication skills

Professionalism

General Appearance, i.e. dress code adhered to

Please comment on the applicant’s character in terms of personality and particular strengths and weaknesses, i.e. initiative, drive, judgment and organisational ability.*

Please comment on the applicant’s suitability to work with vulnerable adults:*

Please comment on any disciplinary action taken against the applicant.

Would you care to make any other comments concerning the applicant?

Confirmation

I believe myself to be suitable for providing a reference for this applicant, and I have answered all questions as honestly as possible.