HERNE BAY HIGH SCHOOL

Reference Request

Name of Applicant
Position Applied for

Please confirm the following details:

The applicants period of employment with you:
The applicants job title:
The applicants reason for leaving your employment:
How long have you known the applicant?
In what capacity do you know them?
Did the applicant perform their duties satisfactorily; if no please provide details

Please tick as appropriate	Excellent	Good	Satisfactory	Poor	Unable to comment
Administrative efficiency
Willingness to work hard
Ability to work independently
Ability to meet deadlines
Commitment to organisation
Ambition
Flexibility
Punctuality
Relationships with colleagues

Additional Comments
Please comment on the effectiveness of the applicant’s interactions with: Adults Children and young people (if applicable)

HERNE BAY HIGH SCHOOL

Reference Request – Safe Recruitment

Herne Bay High School is committed to safeguarding and promoting the welfare of children and expects all staff to share this commitment.

Are you completely satisfied that the applicant is suitable to work with children? Yes No
If no, please provide specific details of your concerns and the reasons for your doubts:
Has the applicant been the subject of a disciplinary action in respect of which penalties or sanctions remain in force? Yes No
If Yes, please give details of the nature and date(s) of the misconduct and of the penalty or sanctions still in force:
Are you satisfied, to the best of your knowledge, that the candidate is not involved in or susceptible to “extremism” being vocal or active opposition to fundamental British values, including democracy, the rule of law, individual liberty and mutual respect and tolerance of different faiths and beliefs? Extremism also includes calls for the death of members of our armed forces, whether in this country or overseas Yes No
Printed Name:
Signature:
Date:
Position:
Organisation:

FOR HERNE BAY HIGH SCHOOL USE ONLY

Date reference received and checked:
Date reference forwarded to relevant party:
Print Name:
Signature:
Job Title:

Date relevant party reviewed reference:
Print Name:
Signature:
Job Title: