Broomwood | GAP reference

Applicant Name

First

Last

Reference Name

First

Last

Company name

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone

Email

Ethnicity

In what capacity have you known the applicant?

How long have you known the applicant?

From

To

Please select the capacity in which you worked with the applicant.

Manager
Coworker
Other

Other (please specify):

Do you consider the applicant to be honest and trustworthy?

Yes
No
Not sure

What attributes do you believe the candidate has for a job in a school? Please feel free to add a letter if you want to expand on any points.

Do you believe that the candidate is physically and mentally fit for work in a school environment?

Suitability for Post:

Do you believe that the candidate has the ability and is suitable to undertake this position?

What makes the candidate particularly suitable for this position? If you do not consider the candidate to be suitable, please elaborate.

Please rate the applicant on the following:

	Excellent	Very Good	Good	Okay	Poor	Not Sure
Honesty	ExcellentHonesty Excellent	Very GoodHonesty Very Good	GoodHonesty Good	OkayHonesty Okay	PoorHonesty Poor	Not SureHonesty Not Sure
Punctuality	ExcellentPunctuality Excellent	Very GoodPunctuality Very Good	GoodPunctuality Good	OkayPunctuality Okay	PoorPunctuality Poor	Not SurePunctuality Not Sure
Motivation	ExcellentMotivation Excellent	Very GoodMotivation Very Good	GoodMotivation Good	OkayMotivation Okay	PoorMotivation Poor	Not SureMotivation Not Sure
Working as part of a team	ExcellentWorking as part of a team Excellent	Very GoodWorking as part of a team Very Good	GoodWorking as part of a team Good	OkayWorking as part of a team Okay	PoorWorking as part of a team Poor	Not SureWorking as part of a team Not Sure
Flexibility	ExcellentFlexibility Excellent	Very GoodFlexibility Very Good	GoodFlexibility Good	OkayFlexibility Okay	PoorFlexibility Poor	Not SureFlexibility Not Sure
Reliability	ExcellentReliability Excellent	Very GoodReliability Very Good	GoodReliability Good	OkayReliability Okay	PoorReliability Poor	Not SureReliability Not Sure
Communication	ExcellentCommunication Excellent	Very GoodCommunication Very Good	GoodCommunication Good	OkayCommunication Okay	PoorCommunication Poor	Not SureCommunication Not Sure

Suitability to Work with Children

In accordance with Keeping Children Safe in Education, we must ask whether you had any safeguarding concerns.

Are you completely satisfied that the candidate is suitable to work with children?

If you are not satisfied, what are your concerns and the reasons why you think the candidate might not be suitable?

Disciplinary Record and Child Protection Concerns:

Has the candidate been subject to any disciplinary procedures relating to the safety and welfare of children? If so please give details.

Have there been any concerns about the candidate’s behaviour towards children or young people? If so, please give details, including the outcome of those concerns and how the matter was resolved. If the candidate’s role involved no contact or responsibility for children or young persons please answer, not applicable.

Signature

Clear Signature

Position

Date

GAP reference

How long have you known the applicant?

Suitability for Post:

Suitability to Work with Children

Disciplinary Record and Child Protection Concerns:

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