Referee – PLUS Care Givers

Referee fORM

Name of Worker *

Name of Referee *

Referee Email Address *

Referee Phone Number *

Referee House Address *

Company Name *

Relationship with worker *

Position / Job Title of worker *

How long have you known the worker/Applicant? *

Candidate's Honesty *PoorGoodExcellent

Candidate's Reliability *PoorGoodExcellent

Candidate's Timekeeping *PoorGoodExcellent

Capable of taking responsibility *PoorGoodExcellent

Good Communication Skills *PoorGoodExcellent

Was their attendance satisfactory *PoorGoodExcellent

Would you recommend the applicant as a Carer / Support Worker (YES /NO) *

Any additional comment on the applicant/worker *

1

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