Reference Request and Release

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Date

{{date}}

Applicant Information

**Applicant Name:** {{applicant_name}}

**ID/Passport Number:** {{applicant_id_passport}}

**Position Applied For:** {{position_applied_for}}

To Whom It May Concern / Reference Provider Details

**Reference Provider Name:** {{reference_provider_name}}

**Reference Provider Title:** {{reference_provider_title}}

**Organisation:** {{reference_provider_organization}}

**Contact Number:** {{reference_provider_phone}}

**Email Address:** {{reference_provider_email}}

Subject: Reference Request for {{applicant_name}}

Dear {{reference_provider_name}} / To Whom It May Concern,

{{company_name}} is currently considering {{applicant_name}} for the position of {{position_applied_for}}. We would be grateful if you could provide a candid assessment of their capabilities, work ethic, and character, based on your professional relationship with them.

Your insights are valuable to us in making an informed hiring decision. Please find below some specific areas we would appreciate your feedback on. Feel free to elaborate on any points you deem relevant.

Information Requested

Please provide information on the following aspects of {{applicant_name}}'s performance and character:

- **Employment Dates:** (If applicable) From {{start_date}} to {{end_date}}

- **Position Held:** (If applicable) {{previous_position}}

- **Key Responsibilities and Achievements:**

- **Strengths:**

- **Areas for Development:**

- **Interpersonal Skills and Teamwork:**

- **Reliability and Punctuality:**

- **Communication Skills:**

- **Problem-Solving Abilities:**

- **Reason for Leaving (if known):**

- **Would you re-employ this individual?** Yes / No / Undecided (Please explain)

Applicant's Consent for Release of Information

I, **{{applicant_name}}**, hereby authorise **{{company_name}}** to contact my previous employers, educational institutions, and listed references to verify the information provided in my application and resume, and to obtain information regarding my employment, education, and character.

I release from all liability and responsibility all persons and organisations providing information in good faith in connection with this application process. I understand that the information obtained will be used solely for the purpose of evaluating my suitability for employment with {{company_name}}.

**Applicant Signature:** ___________________________

**Date:** ___________________________

Confidentiality

All information provided will be treated with the strictest confidence and used solely for recruitment purposes. We kindly request that you complete and return this form, or provide your reference via telephone or email, by {{response_due_date}}.

Should you have any questions or require further information, please do not hesitate to contact {{HR_contact_person}} at {{HR_contact_phone}} or {{HR_contact_email}}.

Thank You

Thank you for your time and assistance in this matter. Your contribution is greatly appreciated.

Signature Block

Sincerely,

___________________________

**{{HR_manager_name}}**

**{{HR_manager_title}}**

{{company_name}}