(including periods for sickness) during the last 12 months of employment? If employed for less than 12 months please give total number of days absent in period of employment
which might make the Applicant unsuitable for employment by us:
If yes please give details
Would you re-employ the applicant?
If no please give details
Please comment on the Applicants strengths
and weaknesses in relations to the position for which he/she has applied (Job Description enclosed)
How many weeks (if any) has the applicant
taken under Parental Leave Regulations?
Your Name
Your Signature
Your Position/Job Title
Date
Company Name
Company Address If you have a Company stamp, please stamp here
If you do not have a Company stamp please
enclose a sheet of Company letterhead or business card N.B. This post is exempt from the Rehabilitation of Offenders Act 1974. In order to protect the public, the post for which application is being made is exempt from Section 4(2) of the Rehabilitation of Offenders Act (Exemptions) Order 1975. It is not, therefore, in any way contrary to the Act to reveal any information you may have concerning conviction which would otherwise be considered ‘spent’ in relation to the Applicants suitability for employment. Any information will be kept in the strictest of confidence and only used in the consideration of the suitability of this Applicant for the position where such exemption is appropriate.