Your Name *
Position Held *
Name of School/Organisation *
Name of Applicant *
Employed From *
Employed To *
Please evaluate the candidate against the following criteria *
Criteria
Performance
Knowledge of the curriculum
—Please choose an option—ExcellentGoodAveragePoorN/A
Attitude
Relationship with Others
Team working
Personal Integrity and honesty
Reliability
Calmness under pressure
Overall performance in past role
—Please choose an option—ExcellentGoodSatisfactoryPoorN/A
Please select an option for every criterion.
Are you satisfied that the applicant is suitable to work with children? * —Please choose an option—YesNo
If No to the above question, please give specific details of your concerns:
Has the applicant been involved with any form of misconduct or disciplinary? * —Please choose an option—YesNo
If Yes to the above question, please give details:
To the best of your knowledge, has the applicant ever had an allegation made against them, which was founded, in regard to his/her behaviour towards children? * —Please choose an option—YesNo
If Yes, please give full details of the nature of the allegation(s), whether any action was taken and, if so, what that was:
Would you re-employ this candidate? * —Please choose an option—YesNo
If No, please give details:
Reason for leaving *
In what capacity do you know them? *
Are you happy for us to share this reference with future employers? * —Please choose an option—YesNo
Are you happy to share this reference with the candidate? * —Please choose an option—YesNo
Additional Comments
In line with Keeping Children Safe in Education 2024, references should be completed by a senior person with appropriate authority. Please sign here to confirm that the headteacher is aware of the content in this reference and has confirmed it is accurate and true in respect of any Safeguarding and/or disciplinary investigations.
Please type your full name *
Please type your email address *
Please type your telephone number *
Terms and Conditions * I understand that the relevant factual content of this reference may be discussed, or provided to the candidate when required by Data Protection law
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