Ringdufferin Nursing Home Reference Form
Name of applicant:
Name of applicant:
Was the applicant previously employed by you?
Was employment terminated?
Would you re-employ the applicant?
Would you consider the applicant to be reliable and a good time keeper?
Would you consider the applicant suitable to work as part of a team?

Please select your opinion of the applicant’s performance level:

Standard of work:
Ability to work unsupervised:
Use of initiative:
Flexibility & Willingness:
Attitudes towards management: