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A Short Word
Referee Questionnaire
First Name
Last Name
Mobile:
Email:
Please answer all the questions below in relation to the applicant.
Q1 - How long have you known the applicant?
SELECT...
Less than 12 months
1 to 2 years
2 to 5 years
More than 5 years
Q2 - What is your relationship to the applicant?
SELECT...
Family
Friend
Work Colleague/Boss
Other
Other Relationship
Q3 - Please comment on the applicant’s skills and characteristics making them suitable to lead/or care and take responsibility for the safety of children and young people.
Q4 - Please give a brief description of the applicant’s personality and character.
Q5 - In your view, what are the applicant’s:
a. Strengths
b. Weaknesses
Q6 - How would the applicant respond to working:
a. Under the leadership of a Team Leader?
SELECT...
They would have some difficulties submitting to authority
They would cope well in this situation
They would thrive and excel in this scenario
I'm unsure of how they would respond.
b. As a member of a team?
SELECT...
They would have some difficulties working in a team
They would cope well in this situation
They would thrive and excel in this scenario
I'm unsure of how they would respond.
c. With members of the opposite sex?
SELECT...
They would most likely struggle in working with members of the opposite sex
Working with members of the opposite sex would not hinder them at all
I'm unsure of how they would respond.
Q7 - How strongly would you recommend this person for work with children and/or young people?
SELECT...
Not at all
I do have some reservations in recommending them
Neutral
I'm happy to reccommend them in this capactity
I highly recommend them as they would be a wonderful asset to the team.
Based on your response to Question 7, please provide further details for you answer.
Q8 - To the best of your knowledge is there any reason the applicant would be considered unsuitable to work with children and/or young people?
They would be suitable for this role
I believe they would be unsuitable for this role
Based on your response to question 8, please provide further details for you answer.
Q9 - Please provide any other comments and/or observations, not already covered in this reference, that may assist us in determining the applicant’s suitability?
Signature
Date of Signing
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