Reference

Request form

Thank you for taking the time to fill this form in

Candidates - Full Name

Your Full Name

Company

How long have you known the applicant and in what capacity?

What would you describe as applicant’s main areas of strength?

Please indicate your assessment of the applicant’s level of the following:

What periods of sick leave/absence has this person had and what were the reasons?

Is there any additional information which you feel is relevant?

Have there been any disciplinary/other formal proceedings against or by the applicant?

Yes

I declare the information is true and correct to the best of my ability.The information you provide will be treated in the strictest confidence. However, you are advised that under the Data Protection Act, all references are potentially disclosable to the applicant. – Thank you very much for your time.

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