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Reference
URGENT: Reference Request
Reference Request: The person named above has applied for employment at Care Angels Homecare Limited to work as Community Support Worker. They have given your name as a person who would be able to supply a reference as to their suitability for the post. We would be grateful if you would click the link below and answer the questions. Click Submit when you are finished. N.B No Login is required Please feel free to write additional comments on a separate sheet if you feel this would be more appropriate. Thank you for your time it is much appreciated.
Referee Name
Referee Position
Name of Organisation
Organisation Contact Number
Please tick if this is a
Employment reference
Character reference
Applicants Name
Applicant’s position
Date of employment
From
DD slash MM slash YYYY
To
DD slash MM slash YYYY
In what capacity is the applicant known to you?
Please give details of responsibilities held and the client group’s applicant has worked with:
Has the candidate ever been disciplined to your knowledge?
Yes
No
Please provide details
Is the applicant able to deal with situations appropriately with regards to confidentiality?
The work involves working with people who might be classed as vulnerable. Do you consider the applicant to be totally honest and trustworthy?
Yes
No
12. Have you any other comment that you feel may be appropriate?
Please rate the applicant on:
Verbal communication
Excellent
Good
Satisfactory
Unsatisfactory
Written communication
Excellent
Good
Satisfactory
Unsatisfactory
General attitude
Excellent
Good
Satisfactory
Unsatisfactory
Honesty
Excellent
Good
Satisfactory
Unsatisfactory
Reliability
Excellent
Good
Satisfactory
Unsatisfactory
Time keeping
Excellent
Good
Satisfactory
Unsatisfactory
Team Skills
Excellent
Good
Satisfactory
Unsatisfactory
Leadership skills
Excellent
Good
Satisfactory
Unsatisfactory
Ability to work unsupervised
Excellent
Good
Satisfactory
Unsatisfactory
Relationship with clients/service users
Excellent
Good
Satisfactory
Unsatisfactory
Relationship with other staff
Excellent
Good
Satisfactory
Unsatisfactory
Would you re-employ this person
Yes
No
If NO please give reasons why:
Please provide any other information that you feel would be of benefit to us?
Thank you for taking the time to complete this reference request form, your feedback and comments are most appreciated.
Name
Position
Signature
Date
DD slash MM slash YYYY
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