Character Reference Form

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Character Reference Enquiry

"*" indicates required fields

Name of Applicant:*

Position Applied for*

Character Referee Details

Referee Name*

Referee Position*

Referee’s Organisation (if applicable)*

Referee’s Contact Number*

Referee’s Email Address*

How long have you known the applicant*

In what capacity have you known the applicant?*

Please rate the applicant on the following areas

Conduct*

Highly Satisfactory	Satisfactory	Unsatisfactory

Timekeeping*

Highly Satisfactory	Satisfactory	Unsatisfactory

Attitude*

Highly Satisfactory	Satisfactory	Unsatisfactory

Work Performance*

Highly Satisfactory	Satisfactory	Unsatisfactory

Reliability*

Highly Satisfactory	Satisfactory	Unsatisfactory

Honesty*

Highly Satisfactory	Satisfactory	Unsatisfactory

Relationships with Colleagues*

Highly Satisfactory	Satisfactory	Unsatisfactory

Ability to meet targets & deadlines*

Highly Satisfactory	Satisfactory	Unsatisfactory

Initiative*

Highly Satisfactory	Satisfactory	Unsatisfactory

Ability to work under pressure*

Highly Satisfactory	Satisfactory	Unsatisfactory

Ability to manage others (if applicable)

Highly Satisfactory	Satisfactory	Unsatisfactory

Please provide comments on the applicant’s suitability for the role of Nursery Room Leader, including their leadership, teamwork, communication skills, and ability to work with children*

How would you describe the candidate’s reliability, professionalism, and ability to create a safe and nurturing environment for children*

To your knowledge, does the candidate have any history of inappropriate behaviour or concerns that would affect their suitability for working with children?*

No

Yes

If yes, please provide details below*

Would you recommend the candidate for this role?*

Yes, without hesitation

Yes, with some reservations (please explain)

No (please explain)

Please provide information*

Have you ever had cause for concern regarding this person’s behaviour or judgment?*

No

Yes

Have you ever had cause for concern regarding this person’s behaviour or judgment?*

Safeguarding Children (To your knowledge, has the applicant been subject to any disciplinary actions related to children or any other issues?)*

No

Yes

Please provide information

Any other comments you would like to add?

Declaration

I confirm that the information provided above is accurate to the best of my knowledge.

Signed*

Print Name

Position

Date*

MM slash DD slash YYYY