Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.NameDate of BirthName of EmployerPosition HeldStart dateEnd dateReason for leaving1. Has this candidate ever been subject of an investigation, disciplinary procedure, or safeguarding concern?YesNo2. Are there any allegations/investigations pending against this candidate?YesNoIf yes to either of the above, please provide details in the additional comments section below.3. If this candidate was available for work again, would you employ them?YesNoIf no to the above, please provide details in the additional comments section below.Relationship with ColleaguesExceptionalVery GoodAbove AverageSatisfactoryBelow AveragePoorPlanning/PreparationExceptionalVery GoodAbove AverageSatisfactoryBelow AveragePoorAbility to work unsupervisedExceptionalVery GoodAbove AverageSatisfactoryBelow AveragePoorProfessional conductExceptionalVery GoodAbove AverageSatisfactoryBelow AveragePoorAppearanceExceptionalVery GoodAbove AverageSatisfactoryBelow AveragePoorTimekeepingExceptionalVery GoodAbove AverageSatisfactoryBelow AveragePoorAdditional CommentsBy returning this reference I acknowledge that:Under the Conduct of Employment Agency/Employment Business Regulations 2003, Niche Education LTD may be required to provide this reference to a client or third party.Print Name *Email *DatePositionSubmit