Reference Request Form

CANDIDATE NAME: POSITION APPLIED FOR:

EMPLOYMENT DETAILS:

CANDIDATE ABILITIES:

In your opinion please rate the candidate on a scale of High, Medium or Low with regards to their professional abilities
and characteristics as observed during their recent employment position with you:

ABILITIES EXCELLENT GOOD MEDIUM LOW

Experience in the same or a similar profession /
position
Ability to work as a team member
Ability to cope in an emergency
Understanding & adhering to policies and procedures
Use of time / Motivation
Punctual / Time Kept
Communication Skills
Flexible
Health & Well Being (whilst employed by you)
Trustworthiness
Reliability
Honesty & Integrity

MIDAS CARE SOLUTIONS

 Would you recommend the candidate for the position? (If ‘No’ please state the reasons why)

Please provide details of any disciplinary action the candidate was subject to during their employment with you?

Would you re-employ candidate? (If ‘No’ please state the reasons why)

Please document any further comments you would like to make, which will assist us in making a fair evaluation of
the candidate’s suitability for the post:

PRINT NAME: TUSO KUDZAI PRAISE

SIGN NAME:

OCCUPATION / POSITION: HRM

FOODWORLD SUPERMARKETS, 42 JASON MOYO, HARARE , ZIMBABWE

COMPANY NAME & ADDRESS:

CONTACT NO.: 770608

DATE:

To confirm authenticity and origin we would ask that you stamp the box provided using a ‘company stamp’. If you do not
have a company stamp please ensure company letter head or a compliment slip is enclosed when returning this reference.

Company Stamp:

Important Information: By virtue of the ‘Rehabilitation of Offenders (Exceptions) Order 1975’ candidates are not able to regard previous
convictions as spent under the ‘Rehabilitation of Offenders Act 1974’. As a referee it is not a contravention of the act to divulge such
information which you consider relevant to the candidate’s suitability for the post. Please be assured that any information you provide will
be treated in the strictest of confidence and will only be used in connection with the application for this post.

MIDAS CARE SOLUTIONS