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Premier Care Ltd
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Applicant Name
Applicant Job Title
Name
Job Title
Referee Email
Company Details
Company Name
Address
(250 chars left)
Start Date
End Date
Still Employed?
Reason For Leaving
Please now rate specific areas of this person's work performance
Reliability + Punctuality
Unsatisfactory
Satisfactory
Good
Very Good
Excellent
Honesty + Integrity
Unsatisfactory
Satisfactory
Good
Very Good
Excellent
Standard of Work
Unsatisfactory
Satisfactory
Good
Very Good
Excellent
Ability to work with others
Unsatisfactory
Satisfactory
Good
Very Good
Excellent
Ability to follow instructions
Unsatisfactory
Satisfactory
Good
Very Good
Excellent
Is this person part of any current disciplinary procedure or investigation
Yes
No
Subject to company policy would you re-employ this individual?
Yes
No
If not why not?
Do you have any other comments that might assist us when assigning this person?
Do you know of any reason why this applicant would not be suitable to work or have contact with vulnerable people, including children, within a care organization?
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