CHARACTER REFERENCE REQUEST FORM

Candidate Name: Matthias Roos

Candidate’s Date of Birth: 08.05.1963

How long have you known the candidate? 5 years

In what capacity do you know the candidate? Friendship

To your knowledge, has the candidate ever had a NO

drink or drugs problem?

If YES, please provide details:

From your knowledge, would you please comment on whether you consider Matthias Roos to be an appropriate
person for the role of Personal Care Assistant working with physically disabled adults with our Company.

Five years ago I got to know Matthias, when he came into my new Pizzeria as one of my first guests. As there were
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not so many guests, we started a conversation and realized that we liked each other. That is why our relationship
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deepened and we became friends. During the years Matthias proved to be someone I could rely on because he is
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a calm and circumspect person who is also very friendly and cooperative. He is also communicative, energetic.
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and adepts to new situations easily.
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Since this post is considered exempt from the provision of the Rehabilitation of Offenders Act 1974 (Exemptions
Order 1986), it would be in order for you to reveal any information you have about any convictions received by this
person. Therefore, please can you provide any information you have:

Not to my knowledge.
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Any other comments: .

None. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Your Name: Nelson Garcia

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Signed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Please post the reference to: Active Assistance, 1 Suffolk Way, Sevenoaks, TN13 1YL, UK

HR-DF0014v1 2014-02-18
 CHARACTER REFERENCE REQUEST FORM

Fax: 01732 779134 or email to: Chloe.Alexander@activeassistance.com

HR-DF0014v1 2014-02-18