Employee Reference Request - St Elizabeth Hospice

Applicant's name*

Previous position held*

Dates Employed

Start date*

End date or state current if still employed*

Performance*

Reliability*

Teamwork*

Honesty*

Time keeping*

Attendance*

Reason for leaving if previous employee

Was the employee the subject of any Capability, Disciplinary or Grievance procedure? If so, kindly provide brief details*

Brief details of procedure*

Would you re-employ this person? If the answer is no, kindly state*

Reason for not wishing to re-employ this person*

Any other comments

Your details

Name*

Job title*

Organisation*

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