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Employment Reference Form

Woodentots Nursery
Employment Reference Form

Applicant Name:

Dates of employment

Date from:

Date to:

Please give a brief description of their role and responsibilities

Details:

Is there any reason, to your knowledge, why the applicant may be unsuitable to work with children?

Yes

If Yes, please give details:

Has the applicant ever been subject to a formal disciplinary/capability procedure during their employment with you?

Yes

If Yes, please give details:

Please rate the applicant against the following criteria:

The applicant's health, attendance and punctuality are excellent:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant is strictly honest, conscientious and discreet:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant is highly competent in all elements of the relevant standards:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant has good levels of literacy and numeracy:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant is able to exercise appropriate control and management of children's behaviour:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant has good listening and communication skillls:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant is able to explain instructions clearly and is able to clarify:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant is professionally discreet and able to respect confidentiality:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant is able to engage with children and act as a positive role model:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

The applicant has developed good working relationships with customers:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Known

Please give any comments you wish relating to the above criteria:

Do you know of any other factors concerning the applicant which might cause their fitness for working with young children to be questioned:

Yes

If Yes, please give further details:

Why did the applicant leave your employment?

Would you re-employ the applicant?

Yes

If No, please give your reasons:

The above information is correct to the best of my knowledge and belief.

Name:

Address:

Tel Number:

Date:

Woodentots Nursery, HMS Collingwood, Newgate Lane, Fareham, Hampshire, PO14 1AS - Tel. 01329 332532

Itseeze Websites (Fareham, Hampshire) - www.itseeze-fareham.co.uk

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Woodentots Nursery Employment Reference Form

Woodentots Nursery
Employment Reference Form