Reference Form – HST Wiltshire

Provide a Reference

A would-be tutor has applied to join us and has given your name as a referee.

We would be very grateful if you would consider the questions on the form.

N.B: If there are any doubts at all concerning this tutor’s suitability for home tutoring, please contact us in confidence.

We will make further checks in accordance with governmental regulations for the protection of children.

Tutor's name

Referee's name

Name of company / employer

Your job role

How long have you known the applicant?

Relationship to applicant

Dates of employment

Job title when working with you

What were the key duties of this applicant?

Their reason for leaving

Would you employ the applicant again?

If no, please give further details

Was the applicant subject to any form of performance management / disciplinary action within the past two years?

If yes, please give further details

This person will be in a position of trust with children/young people. To your knowledge and in your opinion, is there anything in their past history, present manner or circumstances which causes you concern about this?

If yes, please give further details

Is there anything that you are aware of that would prevent the applicant from carrying out the position of tutor?

If yes, please give further details

Did/do you find the applicant to be honest and trustworthy?

Did/do you find the applicant to be reliable?

Did/do you find the applicant capable of fulfilling their duties?

Which subjects and levels would you expect this applicant to be able to tutor, according to their experience or qualifications or to your own knowledge?

If you are able to give us a few more comments about this person, either concerning their professional abilities and / or their personal qualities, we would be very grateful.

Do we have your permission to disclose this reference to the applicant if requested?

Do we have your permission to disclose this reference to clients if requested (if the applicant also gives consent for it to be shared)?

Your signature (e-signatures accepted):

Date

Your address