Your First and Last Name:
Your Address:
Candidates First and Last Name:
Today's Date:
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Contact Phone Number 1:
Contact Phone Number 2:
E-mail:
(Must provide a verifiable contact number in order for reference to be approved!)
Is this a personal or work related reference?
Personal
Childcare Work
Non-Childcare Work
If this is a personal related reference please specify the relation you have to the candidate:
Neighbor
Friend
Relative
Other
How many years do you know the candidate:
If this is a childcare related reference please answer the following 4 questions as well. If this is a personal reference you can skip the next 4 questions.
Between what dates did the applicant work for you?
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to
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1981
1982
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2050
Was this position permanent or temporary?
Was it full time or part time?
Names and Ages of Children When Candidate Started
Typical Hours of the Position
Were any additional duties performed as part of her position? Please check duties performed
Please list five adjectives that best describe the personality of the applicant:
Dependable
Reliable
Cheerful
Loyal
Accommodating
Trustworthy
Punctual
Honest
Responsible
Supportive
Nurturing
Helpful
Good Communicator
Positive
Patient
Committed
Organized
Able to Multi-Task
Involved
Educator
Role-Model
Creative
Professional
Kind
Ethical
Sensible
Dedicated
Genuine
Mild Mannered
Entertaining
Energetic
Considerate
Thoughtful
Understanding
Flexible
Adaptable
Resourceful
Qualified
Interactive
Conscientious
,
Dependable
Reliable
Cheerful
Loyal
Accommodating
Trustworthy
Punctual
Honest
Responsible
Supportive
Nurturing
Helpful
Good Communicator
Positive
Patient
Committed
Organized
Able to Multi-Task
Involved
Educator
Role-Model
Creative
Professional
Kind
Ethical
Sensible
Dedicated
Genuine
Mild Mannered
Entertaining
Energetic
Considerate
Thoughtful
Understanding
Flexible
Adaptable
Resourceful
Qualified
Interactive
Conscientious
,
Dependable
Reliable
Cheerful
Loyal
Accommodating
Trustworthy
Punctual
Honest
Responsible
Supportive
Nurturing
Helpful
Good Communicator
Positive
Patient
Committed
Organized
Able to Multi-Task
Involved
Educator
Role-Model
Creative
Professional
Kind
Ethical
Sensible
Dedicated
Genuine
Mild Mannered
Entertaining
Energetic
Considerate
Thoughtful
Understanding
Flexible
Adaptable
Resourceful
Qualified
Interactive
Conscientious
,
Dependable
Reliable
Cheerful
Loyal
Accommodating
Trustworthy
Punctual
Honest
Responsible
Supportive
Nurturing
Helpful
Good Communicator
Positive
Patient
Committed
Organized
Able to Multi-Task
Involved
Educator
Role-Model
Creative
Professional
Kind
Ethical
Sensible
Dedicated
Genuine
Mild Mannered
Entertaining
Energetic
Considerate
Thoughtful
Understanding
Flexible
Adaptable
Resourceful
Qualified
Interactive
Conscientious
,
Dependable
Reliable
Cheerful
Loyal
Accommodating
Trustworthy
Punctual
Honest
Responsible
Supportive
Nurturing
Helpful
Good Communicator
Positive
Patient
Committed
Organized
Able to Multi-Task
Involved
Educator
Role-Model
Creative
Professional
Kind
Ethical
Sensible
Dedicated
Genuine
Mild Mannered
Entertaining
Energetic
Considerate
Thoughtful
Understanding
Flexible
Adaptable
Resourceful
Qualified
Interactive
Conscientious
In your opinion, did the applicant fulfill all job requirements? Please describe
What is one thing you feel the applicant could improve on?
On a scale of 1 – 10, how would you recommend the applicant for a nanny position?
10 = highly recommend, 1 = absolutely not.
In your own words, please give a detailed description of your experience with the applicant:
Thank you for your attention in this matter.
We may be contacting you again in the future if we are in need of further information
and for verification purposes.
Sincerely,
ABC Nanny Source