Referee Report Form - Australia

This Australia-specific "Referee Report Form" is a document released by the Australian Department of Health.

Download the fillable PDF by clicking the link below and use it according to the applicable legal guidelines.

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Department of Health and Ageing—Referee Report
Candidate Name:
Referee Name:
Referee Contact Number:
Relationship:
1.
How long have you known the candidate?
2.
Were you his/her direct Supervisor?
3.
Could you confirm their position and responsibilities?
4.
(If they have left): What was their reason for leaving?
5.
Can you describe the candidate’s personal integrity and conduct?
6.
Do you have any concerns regarding the attendance record of the candidate?
7.
Did the candidate have any performance issues?
8.
Would you re-employ the applicant? Why/Why not?
9.
What are the candidate’s positive attributes?
‘One APS Career … Thousands of Opportunities’
Department of Health and Ageing—Referee Report
Candidate Name:
Referee Name:
Referee Contact Number:
Relationship:
1.
How long have you known the candidate?
2.
Were you his/her direct Supervisor?
3.
Could you confirm their position and responsibilities?
4.
(If they have left): What was their reason for leaving?
5.
Can you describe the candidate’s personal integrity and conduct?
6.
Do you have any concerns regarding the attendance record of the candidate?
7.
Did the candidate have any performance issues?
8.
Would you re-employ the applicant? Why/Why not?
9.
What are the candidate’s positive attributes?
‘One APS Career … Thousands of Opportunities’
Department of Health and Ageing
Applicant Kit
10.
As referee, please provide comments for each capability in the following section—refer to the
department’s Capability map
for further information.
Capability 1
Capability 2
Capability 3
Capability 4
Capability 5
Capability 6
11.
Are there any areas where the candidate would benefit from further development?
12.
Is there anything further you would like to tell us about the candidate?
Declaration:
I, ___________________________________, confirm that the information above is a true representation
(name of referee)
of my knowledge of the candidate.
:
Signature
Date
Page 2

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