Name of Applicant
Post Applied for
Did the applicant work for your organisation?
If yes, what were the applicant's start and leaving dates?
What is your job title?
How long did you work with the applicant?
In what capacity do you know the applicant? E.g. as a colleague/as an employee reporting to you/other (please specify)
What was the applicant's job title with your organisation?
What were the applicant's main job duties?
What is your assessment of the following elements in relation to the applicant?
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| Quality of work | ||||
| Quantity of work | ||||
| Dedication to the job | ||||
| Ability to work without supervision | ||||
| Working relationships | ||||
| Time keeping |
Did you find the applicant to be honest and trustworthy?
Did you find the applicant to be reliable in carrying out his/her duties?
Does or did the applicant have any live disciplinary warnings with your organisation? If yes, please comment on the nature of these warnings below:
What was the reason for the applicant leaving your organisation?
Did you find the applicant to be honest and trustworthy?
Do you consider the applicant has the ability and is suitable to perform the job described above?
Is the applicant able to demonstrate that s/he meets the requirements of the person specification?
Are you satisfied that the candidate is suitable to work with children?
If you have answered ‘no’ to the above question, please specify your concerns and why you believe the individual may not be suitable.
| Name | |
| Signed | |
| Date | |
| Telephone# | |
| Organisation stamp |
Please provide any further comments on the applicant's suitability for employment into the post described above.