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Please complete the following form:

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    Name of Candidate

    Job Title

    Dates of employment:


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

    Professionalism / conduct
    ExcellentGoodSatisfactoryPoorN/A

    Relationship with pupils
    ExcellentGoodSatisfactoryPoorN/A

    Relationship with colleagues
    ExcellentGoodSatisfactoryPoorN/A

    Classroom management
    ExcellentGoodSatisfactoryPoorN/A

    Knowledge of subject area
    ExcellentGoodSatisfactoryPoorN/A

    Planning and preparation
    ExcellentGoodSatisfactoryPoorN/A

    Quality of teaching
    ExcellentGoodSatisfactoryPoorN/A

    Experience of ICT
    ExcellentGoodSatisfactoryPoorN/A

    Quality of professional judgement
    ExcellentGoodSatisfactoryPoorN/A

    Contribution to wider aspects of school life and ethos
    ExcellentGoodSatisfactoryPoorN/A

    Contribution to own professional development
    ExcellentGoodSatisfactoryPoorN/A

    Has there ever been any safeguarding issue or disciplinary action in regards to the candidate?
    YesNo
    If YES, please provide details about the safeguarding issue or disciplinary action:

    Would you re-employ the candidate?
    YesNoN/A

    Additional Comments


    Details about you

    School/Company:

    Position:

    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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