Reference Request

Reference Request Form

Referee Details:

Applicant Details:

Dates of Employment:

Was the applicant subject to any disciplinary action? YesNo Would You Re-employ the applicant? YesNo

Please rate the applicant on the following:

Attendance: ExcellentVery GoodGoodPoor
Productivity & Work ethic: ExcellentVery GoodGoodPoor
Quality of work: ExcellentVery GoodGoodPoor
Reliability: ExcellentVery GoodGoodPoor
Communication & Organisational Skills: ExcellentVery GoodGoodPoor
Team Fit & Relationship with colleagues: ExcellentVery GoodGoodPoor
Punctuality: ExcellentVery GoodGoodPoor
Honesty & Integrity: ExcellentVery GoodGoodPoor

Please use this box for any additional comments you might like to add:

Signature:

Clear Confirm Signature

I confirm all details submitted are correct and the signature is a true likeness