[vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” text_align=”left” background_image_as_pattern=”without_pattern” padding_bottom=”40″][vc_column width=”2/3″][vc_column_text css=”.vc_custom_1457131298139{margin-bottom: 20px !important;}”]

Please complete the following form:

[/vc_column_text]

    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

    [/vc_column][vc_column width=”1/3″][vc_single_image image=”1521″ border_color=”grey” img_link_target=”_self” qode_css_animation=”element_from_right” img_size=”full”][/vc_column][/vc_row]