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Reference request form

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This form can be sent standalone to a referee nominated by the new employee, or alongside a cover letter. It requests confirmation of dates of service and suitability for the role.

Reading time
How long to understand and implement this form?
5 mins
Word count
How many words in this form?
208
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What is a Reference request form?

The purpose of this Reference request form is to provide you with a flexible and customisable document to serve as a robust and effective starting point for you.

By using our Reference request form, you can streamline your process, maintain consistency and accuracy, and save time, and it can be easily adapted to fit your specific scenario.

Issued by who, to whom
Who should issue this form, and to whom?
The Employer (you) to the Company (you)
Applicable legal jurisdictions
In which jurisdictions can this form be used?
Great Britain & NI (United Kingdom), Worldwide

Reference request

Reference request: [insert job title], [insert name of applicant]

The person named above has applied for a job with this company and has given your name as someone who we can contact for a reference.

I would be most grateful if you would confirm the employment details and give comment on the persons suitability based on the requirements of the job.

Applicants position with your firm:  
Employed from:  
Employed to:  
[Final salary:]  

Please rate the applicant on the basis of his or her employment with you (good/fair/poor):

Ability:  
Conduct:  
Efficiency:  
Attendance:  
Punctuality:  
Reason for termination:  
Would you re-employ? (if NO, give reason): YES / NO

I confirm that the information provided in this form is correct to the best of my knowledge.

Signed (employee):  
Position:  
Date:  

Version: [1.0]

Issue date: [date]

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In which communication or process sequence does this template belong?

Previous step
Letters
Reference request letter template

If you are recruiting a new employee and wish to request a reference from a previous employer, send this this model letter template to request confirmation of their employment.

This step
Reference request form template
Next step
Letters
Reference completed (where form is provided) letter template

Our Reference Completed Letter Template streamlines the process of providing detailed and accurate employee references, saving time and effort.

reference request form