HOMESHARE ONLINE REFERENCE FORM - SUPPORTMATCH HOMESHARE

REFEREES DETAILS

YOUR FULL NAME*

Name of the person providing the reference (Your Name)

Your Email Address (Referee)*

A copy of this completed reference form will be sent to your email address

Your Telephone (Referee)

APPLICANT REFERENCE

HOMESHARER/GUARDIANS FULL NAME (Person you are providing references for)*

Name of the person you are providing a reference for!

How do you know the Homeshare/Guardianship applicant and in what capacity*

How long have you known the applicant (Years)*

What did you regards as their strengths*

What do you regard as their weaknesses*

Applicants willingness to take responsibility*

Thoughtfulness and consideration to others*

Trustworthiness*

Stability of their personality (i.e subject to large mood swings or not)*

Positive outlook on life*

Reliability*

General energy levels*

Ability to be positively assertive when needed*

If you had an elderly relative or friend, can you see the applicant living with them as a Homesharer*

What characteristics in your view would make the the applicant a SUITABLE candidate for Homeshare*

In your view, what characteristics would make this candidate UNSUITABLE for Homeshare*

Please provide any other comments you feel relevant to this candidates application (e.g relations with colleagues, attendance record, etc)*

(A) As the Referee, I agree to give Support&Match CIC and Supportmatch Homeshare Ltd permission to use the information that I have provided in this Reference Form. I also consent to Support&Match CIC and Supportmatch Homeshare Ltd to use the information I have provided in this Reference form at their discretion and in support of the Homeshare Candidate's application to be enrolled as a Homesharer with Support&Match CIC and/or Supportmatch Homeshare Ltd.

I HEREBY CONFIRM, CONSENT AND AGREE TO THE TERMS ABOVE (A)*

YES I AGREE

NO I DO NOT AGREE

SUBMIT DATE (Admin)

IMPORTANT

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