Reference Form
Use this form to provide a reference.
Referee Details
Referee Name
*
Referee Company
*
Referee Job Title
*
Employee Details
Employee First Name
*
Employee Surname
*
Position Employed As
*
Company
*
Employed From
*
Format: DD/MM/YYYY
Employed To
*
Format: DD/MM/YYYY
Reason for Leaving
*
Number of Days Sickness
*
Applicant's Conduct
*
Poor
Fair
Good
Excellent
Applicant's Conduct Additional Comments
Reference Questions
Standard / Quality of Work
*
Poor
Fair
Good
Excellent
Standard / Quality of Work Additional Comments
Response to Supervision
*
Poor
Fair
Good
Excellent
Response to Supervision Additional Comments
Conduct / Attitude
*
Poor
Fair
Good
Excellent
Conduct / Attitude Additional Comments
Honesty / Integrity
*
Poor
Fair
Good
Excellent
Honesty / Integrity Additional Comments
Technical Ability
*
Poor
Fair
Good
Excellent
Technical Ability Additional Comments
Relationship with Colleagues
*
Poor
Fair
Good
Excellent
Relationship with Colleagues Additional Comments
Timekeeping / Reliability
*
Poor
Fair
Good
Excellent
Timekeeping / Reliability Additional Comments
Attendance
*
Poor
Fair
Good
Excellent
Attendance Additional Comments
Flexibility
*
Poor
Fair
Good
Excellent
Flexibility Additional Comments
Reliability
*
Poor
Fair
Good
Excellent
Reliability Additional Comments
Final Section
Is it your company policy to re-employ?
*
Select an option
Yes
No
Would you re-employ?
*
Select an option
Yes
No
Submit Reference
