Reference Request Form

Applicant Name: Fathima Shifa

Dates Employed: Jan 2019 till Jan 2022

Position Held: Preschool Teacher

Name of Organisation: Women’s Development Association – Sabaragamuwa Province, Sri Lanka

General Skills

Outstanding Good Satisfactory Requires

Improvement
Attendance and Punctuality *
Written and Verbal Communication *
Ability to maintain professional boundaries *

Do you have any concerns about the candidate working with children, Yes / NO
If Yes, please elaborate.
No

Has this person ever been disciplined whilst in your employment? Yes / No
If yes, please elaborate
NO

Are you happy for this reference to be shared with a prospective employer? Yes / No
Yes

Please provide any further comments you feel would assist us in finding this applicant future
employment within the Education sector

Signed: Date: 02/02/2023