Reference Request form for Extra Help 

Extra Help is a home help company providing domestic cleaning, housekeeping services, enabling and support work, basic gardening and much more. Someone has used you as a reference for a role with us, please could you take a few minutes to outline some details below.

Your Name *

Your Email Address *

Your Phone Number *

Referee/Applicant Name *

Which branch are they applying to work in? *I am unsureI am unsureBarnetBirmingham (North) and Sutton ColdfieldBirmingham EastBirmingham SandwellCotswoldChelmsfordDevon South or West inc Torbay, Dartmoor, South HamsDevon North, Mid, East and ExmoorEast HertsExeterGuildfordHammersmith & FulhamHuntingdonshireLeicestershire North WestMaidenhead and WindsorMilton KeynesMonmouthNewcastle Under LymePlymouthPooleSomerset NorthShropshireSlough and West DraytonSt AlbansSurrey EastWirralWolverhampton

How do you know the applicant? *OtherThey worked for meThey worked with meI know them personallyOther (expand in box below)

How long have you known the referee (if applicable how long did they work for or with you please include dates (month and year) and company name)? *

Your reference (include competency, manor, conduct, attitude, honesty, work ethic and reason for leaving role if professional reference plus any disciplinary records if applicable) *0 / 180

Would you recommend the applicant for a role with vulnerable clients? *YesNoPrefer not to say

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Thank you for your time today!

If you would like to find out more about Extra Help please contact your local branch. By submitting this reference you are giving us permission to record your details and make use of them in order to deal with the reference for this applicant. We may phone or email you to ask for additional information if required.