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Reference Request Form

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Reference Request

Who are you giving a reference for?

What type of reference are you giving?

Professional

Personal

Professional Reference

What is the name of the company you work for?

What is your full name?

What is your job title?

What is the job title of the individual you are providing a reference for?

When did they start work with you?

When was their final day of work with you?

How many days sickness did the individual take in the last 12 months?

This is not including any absences related to disability or to parental rights, for example maternity leave.

What were their main duties?

Are you aware that the applicant has ever been convicted of any offence?

Yes

No

Signature

Personal Reference

What is your full name?

What is your relationship to the individual?

How long have you known the individual?

Please provide some comments on the individuals character and strengths

Do you feel the individual is suitable for this new role?

Signature

If you are human, leave this field blank.

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