Aesthetics Reference Check Form

The person named below has applied for the stated post within our organisation and has given your name as a referee. It would be greatly appreciated if you could answer all relevant questions, sign and date the form, and submit as soon as possible.

Name of Applicant: *

Position Applied for: *

Company: *

Referee

Referee’s Name:

Referee’s Email:

Referee's Contact Number:

Company / Organisation Name:

Company / Organisation Address:

Type of Reference:

In what capacity do you know the applicant?

How long have you known the applicant?

Date Employed / Known from:

Date Employed / Known to:

Applicant's previous job title:

Responsibilities:

Applicant's previous salary:

$

Reason for leaving:

Number of days absent through sickness/injury during employment:

Assessment of Performance

Please rate the person on the following:

Teamwork:

Honesty:

Punctuality:

Reliability:

Attitude:

Professionalism:

Other Information

Based on your knowledge of the applicant, do you feel that they have the ability to carry out the duties for this position?

In your opinion is there any reason why the applicant should not be appointed to this post?

Do you have any further information or comments which you would wish to offer about the applicant, bearing in mind the post for which they have applied?

Referee's Signature: *

Set a reminder:

Data Protection

If the applicant is successful the information will be held on file for the duration of their employment. If the applicant is unsuccessful the information will be held on file for a maximum of twelve months and then destroyed.