CHARACTER REFERENCE REQUEST FORM

Applicant’s Name: Sumaiya Jannat Reference Date: 08/10/2023

The above applicant has applied with our company for Agency staff Care Assistant position. Would you be
kind enough to provide us with your written evaluation of this individual in the space below.

She was very hard working and punctual person. She has great sense about her responsibilities and had
patience and commitment to fulfill them. She always looked after patients and vulnerable people with the
great care and attention and supported them as their needs. I wish her great success for her new career and
for her future. Should any other information needed please don't hesitate to contact us.

Kind regards
Salim Ahmed

Are you aware of any longstanding or re-occurring health problems? Yes No (Please circle)

Has the applicant ever been cautioned or convicted of a criminal offence? Yes No don’t know
(Please circle). If yes please specify.

Is there any other information or comment you wish to make in respect of the applicants suitability for the
position.

Name: Salim Ahmed Signed:..........................................Date: 08/10/2023

Relationship to applicant: Previous employer

Full address and contact details: Al Barakat Mansion, Kodomtoli Point, Sylhet.
Tel: +8801717-725177

Please return the form to the address above