Candidate Full Name
Your Full Name
Your Phone number
Please outline below the relationship you have, or had, to the Candidate
How long have you known the candidate?
Do you consider this person to be honest and trustworthy?
If NO, please provide additional details below
Please provide any further information here including, if possible, the main areas of responsibility and
achievements to date along with any skills or potential areas of weakness you have noted
DECLARATION : I confirm that the information provided is accurate and complete and consent to being contacted should
further clarity on the reference be required.
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