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Reference Request Form
Reference in respect of:
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Your Name:
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First
Last
Length of time you have known him/her:
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Are you aware of any reason why this person might not be suitable to work with children?
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Are you aware of any previous disciplinary action taken against this person where there were concerns relating to children’s safety or protection? If so, please give details:
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Are you aware of any current investigations or of any disciplinary sanctions, which remain against this person? This may or may not be related to children’s safety and protection. If so, please give details:
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Please comment on the applicant's qualities in relation to the following
Honesty:
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Reliability:
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Punctuality:
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Please comment on the applicant’s suitability and overall ability to work with children:
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Please add any further information or comments that you feel are relevant to the applicant becoming a Host Family with Opportunity Education:
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Your details:
Email address:
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Organisation/Company you work for:
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Position:
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Telephone number:
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