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Cleaner Reference Check Form

Helps a cleaning company verify a job applicant's background by collecting structured feedback from personal or professional references before extending an offer.

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Reference request for (please insert first and last name of the person we have contacted you about):*

Nombre

Apellido

Please complete the following reference details

Your name*

Nombre

Apellido

Address*

Dirección

Ciudad

Estado / Provincia

Código postal

Your occupation*

How long have you known the applicant?*

In what capacity do/did you know the applicant?*

Personally Professionally

If personally, please explain the relationship:

If professionally, over what period was the applicant employed/did you work with the applicant? (Please give a year range such as 2014 - 2016):

If professionally, please explain the relationship (for example your job title and job description and the applicant's job title and job description):

If professionally, what was the reason the applicant left? (If they are still employed, please state 'still employed').

Would you re-employ or work with the applicant again? (Leave blank if not applicable).

Yes No

Please select which attributes you feel best describe the applicant (please complete this section as it is very important for our records):

Reliable Hardworking Trustworthy Punctual Attention to detail Good communicator

Additional information:

If we take on this applicant and one of our Householders wishes to see this reference, would you be amenable to us passing this on? (Your personal/contact details would not be included).*

Yes No

Thank you for completing this reference.

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