Teaching Assistant Reference Form REFERENCE REQUEST FORM In writing your reference, please note that, in order to protect children, the post for which application is made is exempt from section 4(2) of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. It is not, therefore, in any way contrary to the Act to reveal any information you may have concerning convictions/bindovers/cautions which would otherwise be considered as ‘spent’ in relation to this application and which you consider relevant to the applicants suitability for employment. Any such information will be kept in strict confidence and used only in consideration of his/her suitability. Name of Applicant * Job Title * Applicant Job Role Name of Referee * Referee Email Address * Name and address of school * Start date of employment * End date of employment * Reason for leaving * Relationship with Staff * Please SelectExcellentGoodSatisfactoryUnsatisfactory Relationship with Children * Please SelectExcellentGoodSatisfactoryUnsatisfactory Relationship with Parents * Please SelectExcellentGoodSatisfactoryUnsatisfactory Pupil behaviour skills * Please SelectExcellentGoodSatisfactoryUnsatisfactory Did you find the individual to be honest and trustworthy? * Yes No Did you find the individual to be reliable? * Yes No Did you find the individual capable of fulfilling their duties? * Yes No General comments Was the candidate subject to any formal form of performance management/disciplinary action? * Yes No If Yes, please give further details Are you aware of any issues with the applicant in relation to Safeguarding & Child Protection? * Yes No If Yes, please provide details Would you re-employ? * Yes No If No, please give a reason Signature * signature keyboard Clear Position * Date * Are we able to disclose this reference to the above named applicant * Yes No Can this reference be given to the potential employer * Yes No If you are human, leave this field blank. Submit
