Name of Candidate

Job Title

Please mark N/A if not applicable – Please complete all fields

Professionalism / conduct

ExcellentGoodSatisfactoryPoorN/A

Relationship with children and young people

ExcellentGoodSatisfactoryPoorN/A

Relationship with colleagues / friends

ExcellentGoodSatisfactoryPoorN/A

Reliability

ExcellentGoodSatisfactoryPoorN/A

Honesty

ExcellentGoodSatisfactoryPoorN/A

Punctuality

ExcellentGoodSatisfactoryPoorN/A

Suitability for working with children

ExcellentGoodSatisfactoryPoorN/A

Computer skills

ExcellentGoodSatisfactoryPoorN/A

Quality of judgement

ExcellentGoodSatisfactoryPoorN/A

Behavioural management

ExcellentGoodSatisfactoryPoorN/A

Contribution to own professional development

ExcellentGoodSatisfactoryPoorN/A

Are you aware of any safeguarding issue or disciplinary action with regard to the candidate?

YesNo
If YES, please provide details of the safeguarding concern or disciplinary action:

To your knowledge, has the candidate ever been dismissed from a childcare position?

YesNoN/A
If YES, please state the reason for dismissal:

Additional Comments

Details about you

Length of time you have known the candidate:

Relationship:

Your job title:

Your Name:

Your Email:

Date:

Please confirm:

I confirm I am the named referee or act on behalf of the named referee and the information provided is true to the best of my knowledge

I understand that under the Conduct of Employment Agency and Employment Business Regulations 2003, and in accordance with DfE guidance, Worldwide Education may be required to provide this reference to prospective employers