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Please complete the following form:

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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

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