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Name Relationsh
ip
Date of Reference Person Checking
Check Reference
If a former employer, what position did candidate hold? Describe his/her job responsibilities.
The applicant is being considered as a Nursery Child Caregiver. Do you think he/she is a good fit?
Have you observed the applicant working with children under the age of five?
On a scale from 1-5, how would you rate his/her work performance? (1 is poor and 5 excellent)
How would you describe the applicant's energy level and stamina?
Is there anything else you would like to add about this applicant?
Page 1 of 3
[Form 4] Nursery Staff
Reference Check Form
Name Relationsh
ip
Date of Reference Person Checking
Check Reference
If a former employer, what position did candidate hold? Describe his/her job responsibilities.
The applicant is being considered as a Nursery Child Caregiver. Do you think he/she is a good fit?
Have you observed the applicant working with children under the age of five?
On a scale from 1-5, how would you rate his/her work performance? (1 is poor and 5 excellent)
How would you describe the applicant's energy level and stamina?
Is there anything else you would like to add about this applicant?
Page 2 of 3
[Form 4] Nursery Staff
Reference Check Form
Name Relationsh
ip
Date of Reference Person Checking
Check Reference
If a former employer, what position did candidate hold? Describe his/her job responsibilities.
The applicant is being considered as a Nursery Child Caregiver. Do you think he/she is a good fit?
Have you observed the applicant working with children under the age of five?
On a scale from 1-5, how would you rate his/her work performance? (1 is poor and 5 excellent)
How would you describe the applicant's energy level and stamina?
Is there anything else you would like to add about this applicant?
Page 3 of 3