Reference Request Personal DetailsApplicant's Name First Last Position Applied ForReferee's PositionReferee's NameReferee's OrganisationDates of employmentReason for leavingDate MM slash DD slash YYYY Applicant's PerformanceLesson planning Excellent Good Satisfactory Poor Lesson content Excellent Good Satisfactory Poor Adaptability of teaching style Excellent Good Satisfactory Poor Rapport with students Excellent Good Satisfactory Poor Relationships with colleagues Excellent Good Satisfactory Poor Submission of paperwork Excellent Good Satisfactory Poor Has the applicant been subject to any disciplinary procedures? Yes No Do you have any concerns about the applicant's suitability to work with children? Yes No Any further comments: