Confidential Reference

Guidance and Privacy Notice

Thank you for taking the time to fill in this form as part of our safer recruitment of volunteers. Please answer all questions.

The accompanying Privacy Notice explains how the information you supply on this form is used and your rights with respect to that data as required by the UK General Data Protection Regulation, (the ‘UK GDPR’), and the Data Protection Act 2018, (the ‘DPA 2018’).

Call 07923 384047 if you have any queries about completing this form.

Section A

Your relationship with the applicant

1. Please enter the full name of the applicant. *You will enter your details at the end of the form

2. In what capacity do you know the applicant? *

3. How long have you known the applicant? *

Section B

Your knowledge of the applicant

4. With your knowledge and experience of the above person, how confident are you of their suitability to work with children/adults who are vulnerable? *

5. With your knowledge and experience of the above person, how confident are you of their previous experience of working with children / adults who are vulnerable? *

6. With your knowledge and experience of the above person, how confident are you of their ability to provide kind, consistent and safe care? *

7. With your knowledge and experience of the above person, how confident are you of their willingness to respect the background and culture of children/adults who are vulnerable and to treat everyone with equal concern? *

8. With your knowledge and experience of the above person, how confident are you of their honesty, reliability, health and experience of working with children/young people/vulnerable adults? *

9. Are there any other comments you would like to make about the applicant?

10. Are you aware of any health concerns relevant to working with children/adults who are vulnerable that need to be taken into account? *

11. Please give further details of these health concerns. *

12. Have you any evidence or concerns that this person is not suitable for work with children/vulnerable adults? *

13. Please give further details of the evidence or concerns. Your comments will be treated in confidence. You may wish to call the number at the top of this form to discuss these details. *

Section C

Your details

14. Please enter your full name. *

15. Please tick to confirm that you have answered all questions truthfully, honestly and to the best of your knowledge. *I have

Please enter your email address *We will email you a copy of this reference

Please enter your phone numberSo we can contact you for any further information