1. APPLICANT

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2. REFEREE

Refereeā€™s Name

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Are you a Previous Employer of the Applicant?

3. APPLICANT SUITABILITY QUESTIONNAIRE
HONESTY
TRUSTWORTHINESS
STANDARD OF WORK/PERFORMANCE
VERBAL COMMUNICATION SKILLS
WRITTEN SKILLS
WORK WITHOUT SUPERVISION
ABILITY TO COPE UNDER PRESSURE
INTER-STAFF RELATIONSHIPS
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CARING NATURE

Please confirm the dates of employment?

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How many days did the applicant take off as sick leave in the last year?

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What were the reasons for leaving your employment?

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Would you re-employ this person?

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4. REFERENCE ON CHARACTER AND PERSONALITY

How long have you known the applicant? (in days)

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What is your relationship to the applicant?

If you would please comment on the applicant below