| Name of applicant: | ||
| 1. In what capacity do you know the applicant? (e.g. as a former employee, friend, etc) | ||
| 2. How many years have you known the Applicant? | ||
| 3. In your opinion is the applicant an honest and reliable person? | ||
| 4. Please write here any other comments you would like to make regarding the applicant, and which would be of interest to a prospective employer.
(Please continue on a separate sheet if necessary)
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| (Questions 5-8 to be answered by former employers only) | ||
| 5. (a) Please state the dates during which the applicant was employed by you or your organisation and in what capacity they were employed. | ||
| (b) During the period the applicant was employed by you, would you say their timekeeping was:
(i) good (ii) average, or (iii) below average? |
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| (c) (i) how many days sickness has the applicant taken in the last year?
(ii) how many periods of sickness has this consisted of? |
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| (d) Did the applicant take parental leave and if so:
(i) for how long; and (ii) what was the name of the child? |
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| 6. Would you re-employ the applicant? If not, why not? | ||
| 7. What was the applicant’s reason for leaving your employment? | ||
| 8. What was the applicant’s salary at the time of leaving? | ||
| Is this reference given in confidence? | YES/NO (delete as appropriate) |
| Signed:
(if applicable company stamp) |
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| Name of person signing: | |
| Date: |