Professional Reference Form

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Thank you for providing us with this reference.

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At Choices we support vulnerable young people and children.

As part of our Safer Recruitment Guidelines and to meet the requirements of our regulatory body, Ofsted, we are required to confirm if the individual has been involved in:

Any safeguarding matters
Potential risk to young people or children whilst employed by your company
Any disciplinary or dismissal
Reason for leaving

Applicants working in a care setting need to be of good character and there must be no impediment to John Doe being employed in a situation where John Doe would have responsibility for the care of young people and children.

Important: By regulation, we must give any previous employer the opportunity to formally confirm that there is no reason why the applicant cannot work with young people or children.

Please note, in accordance with the Data Protection Act 2018 the information given may be shared with the applicant.

Applicant Provided Information

Applicant name

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Application address

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Applicant Postcode

9974563210

Applicant NI Number

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Applicant date of birth

26-1-1990

Position employed As

staff

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Employed from

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Employed to

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Education & Training

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Do these records match your records?

Date you have known the applicant from

Date you have known the applicant to

Has the applicant been subject to any disciplinary action?

Do you think the applicant would be suitable to work with vulnerable adults, young people or children?

Please highlight any positive aspects of the applicants work:

Are there any concerns regarding the applicant’s work?

Please explain why the candidate left your employment?

Would your company re-employ this person?

Any additional comments

Could you please indicate the applicants overall performance in the following areas

Honesty

If Ok, Poor or Very Poor, please state why

Attendance

If Ok, Poor or Very Poor, please state why

Timekeeping

If Ok, Poor or Very Poor, please state why

Flexibility

If Ok, Poor or Very Poor, please state why

Caring Skills

If Ok, Poor or Very Poor, please state why

Ability to take charge

If Ok, Poor or Very Poor, please state why

Communication Skills

If Ok, Poor or Very Poor, please state why

Report writing skills

If Ok, Poor or Very Poor, please state why

Undertaking tasks

If Ok, Poor or Very Poor, please state why

Working as a team

If Ok, Poor or Very Poor, please state why

Dealing with colleagues

If Ok, Poor or Very Poor, please state why

Dealing with management.

If Ok, Poor or Very Poor, please state why

Ability to take initative

If Ok, Poor or Very Poor, please state why

Organisation ability

If Ok, Poor or Very Poor, please state why

Ability to make sound balanced judgments?

If Ok, Poor or Very Poor, please state why

Ability to cope under pressure?

If Ok, Poor or Very Poor, please state why

Do you know of any criminal or unlawful activities this person may have been involved in?

Please confirm your details

Name

Position

Company Name

Contact Number

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Do these records match your records?

Date you have known the applicant from

Date you have known the applicant to

Has the applicant been subject to any disciplinary action?

Do you think the applicant would be suitable to work with vulnerable adults, young people or children?

Please highlight any positive aspects of the applicants work:

Are there any concerns regarding the applicant’s work?

Please explain why the candidate left your employment?

Would your company re-employ this person?

Any additional comments

Could you please indicate the applicants overall performance in the following areas

Honesty

Attendance

Timekeeping

Flexibility

Caring Skills

Ability to take charge

Communication Skills

Report writing skills

Undertaking tasks

Working as a team

Dealing with colleagues

Dealing with management.

Ability to take initative

Organisation ability

Ability to make sound balanced judgments?

Ability to cope under pressure?

Do you know of any criminal or unlawful activities this person may have been involved in?

Please confirm your details

Name

Position

Company Name

Contact Number

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