Reference Form
Candidate name:
Position applied for:
Name of referee:
Referee’s position & company:
Relationship to candidate:
Referee email & phone number:
Position(s) candidate held in your Title Start Date End Date
organization as well as dates of
employment:
Reason for leaving: Resignation End of contract/Assignment
Dismissal Post abolishment
If dismissal, please clarify
1. How would you describe the candidate’s overall performance?
Excellent Very good Good Fair Poor
Please justify:
2. How would you describe the candidate’s teamwork and collaborative behaviour?
Excellent Very good Good Fair Poor
Please justify:
3. How would you describe the management and leadership skills of the candidate, if applicable?
Excellent Very good Good Fair Poor
Please justify:
4. Describe the candidate’s ability to work in a diverse work environment, including with colleagues from
various professional backgrounds and cultures.
5. Describe the written and verbal communication skills of the candidate.
6. What were the candidate’s key accomplishments?
Thank you for taking time to fill this form. The information you have shared will be handled in strictest
confidentiality.
7. What area(s) of development could the candidate focus on, if any?
8. Do you have any comments about the candidate’s ability to perform the duties of this position?
9. How would you rate the level of respect of/adherence to rules, regulations, processes and expected
behaviours, e.g., code of conduct, in your organization by the candidate?
Excellent Very good Good Fair Poor
Please provide any specific comments:
10. Was the candidate the subject of a disciplinary action(s)? Yes No
If so, please provide details on the nature of the allegations and the outcome of the disciplinary process,
including sanction.
11. Was the candidate found to have committed misconduct involving sexual abuse, sexual exploitation or
sexual harassment?1 Yes No
If so, please provide details on the nature of the allegations and any subsequent disciplinary action taken,
including sanctions.
12. Are you aware of any concerns or complaints that were made about the candidate in connection with
working with, or having contact with children? Yes No
13. Would you re-hire this candidate if given the opportunity? Yes No
Additional comments:
14. Please feel free to provide any further information you feel is relevant to employment with Village
Enterprise.
Signature: Date:
1
Village Enterprise applies the following definitions: Sexual Abuse: An actual or threatened physical or psychological
intrusion of a sexual nature, whether by force or under unequal or coercive conditions when committed against
Affected Persons. Affected Persons refers to persons who look to or benefit from Village Enterprise assistance. This
may include any person in the country or local community where the VE is operating; Sexual Exploitation: Any
actual or attempted abuse of a position of vulnerability, differential power or trust for sexual purposes with respect to
Affected Persons, including, but not limited to, profiting monetarily, socially, or politically from the sexual exploitation of
another. Any payment (through cash or any other commodity or favour) for sexual services is considered to constitute
sexual exploitation; Sexual Harassment: Any unwelcome sexual advance, request for sexual favour, verbal or
physical conduct or gesture of a sexual nature, or any other behaviour of a sexual nature (including pornography,
sexually-coloured remarks, etc.) that has or that might reasonably be expected or perceived to cause offence or
humiliation to another.
Thank you for taking time to fill this form. The information you have shared will be handled in strictest
confidentiality.