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Pre-Employment Reference Request Form

Pre-Employment Reference Request Form

Candidate Information

This data is pre-filled if you click the link from your email notification
This data is pre-filled if you click the link from your email notification
It is essential that the candidate be of good character, in sound health both in body and mind, willing to conform to such rules of discipline as are essential to the agency.

We would be most grateful if you could complete and return this form as soon as possible in the envelope provided. Please furnish me with the details of the applicant’s character, conduct, and suitability for the post shown as above as fully as you are able, with any additional comments you consider necessary to give a true and full reflection of the applicant’s abilities.

Thank you

Reference Details

(Your Name) This data is pre-filled if you click the link from your email notification
(Your Email Address)
(If Applicable)

Employment Details

Please state how many days approximately the applicant has taken as leave during the last 2 years

Workplace Conduct

Attitude to co-workers?
Ability to work under pressure?
Applicable knowledge and skills?
Please comment on those items marked “Average” and “Poor
Has the applicant ever had any disciplinary action taken against them?

The post for which the applicant has applied for is made exempt from section (42) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Act 1974 (Exceptions) Order 1975. It is therefore contrary to the act to reveal any concerning convictions which would be otherwise ‘spent’. As this would be relevant to the applicant’s suitability for employment you should not withhold such information.

If yes please include details and dates of allegations only if substantiated


Would you like to receive some information regarding the services offered by MHP?
EAA Regulations 2004
Because the staff we supply work with vulnerable people, in line with the EAA Regulations 2004 we are obliged to disclose the above information to relevant third parties. Do we have Permission to do so?
Show to 3rd Parties?
Reference Authentication

Maximum file size: 5MB


London, Lewisham, Riverdale,
132 Lewisham High St, Romer
House, 1ST Floor, London
SE13 6EE


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