"Standard Reference Request Form - Sample"

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(DBS 7)
STANDARD REFERENCE REQUEST FORM: EMPLOYEES
STRICTLY CONFIDENTIAL
Candidate’s name:
Job applied for:
Name of referee: (please print)
Contact phone number:
Do you currently employ the candidate?
Yes/No
Give dates of employment with you: From:
To:
Give brief details of current duties and responsibilities in the organisation:
Total salary received
£
In what capacity are you giving this reference? (i.e. manager, friend, college tutor etc)
How long have you known the candidate?
Please comment on your opinion of the candidate in the following areas:
Suitability for the job applied for:
Your overall impression of the candidate’s work:
His/her ability to form and maintain effective working relationships at all levels:
Has the candidate ever been subject to disciplinary action? If yes, please give details:
(DBS 7)
STANDARD REFERENCE REQUEST FORM: EMPLOYEES
STRICTLY CONFIDENTIAL
Candidate’s name:
Job applied for:
Name of referee: (please print)
Contact phone number:
Do you currently employ the candidate?
Yes/No
Give dates of employment with you: From:
To:
Give brief details of current duties and responsibilities in the organisation:
Total salary received
£
In what capacity are you giving this reference? (i.e. manager, friend, college tutor etc)
How long have you known the candidate?
Please comment on your opinion of the candidate in the following areas:
Suitability for the job applied for:
Your overall impression of the candidate’s work:
His/her ability to form and maintain effective working relationships at all levels:
Has the candidate ever been subject to disciplinary action? If yes, please give details:
(DBS 7)
Have you ever had any reason to doubt the candidate’s honesty or integrity?
Would you re-employ this candidate? If no, please give details:
Give details of the number of days and the number of occasions of sickness absence taken in
the last 2 years:
Any other comments you may wish to make which are pertinent to the application:
Information given is treated in confidence.
Please continue your answers on a separate page if necessary.
Signed: ___________________________
Date: ___________________
Company stamp:
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