Confidential reference form * Required Field Your details Your first name*: Your surname*: Your home address*: Your phone number*: Have you travelled with HCPT within the last five years?* Yes No If you answered YES to the question above, please tell us which Group(s), and when: About the applicant Please accept this reference for: Applicant's first name*: Applicant's surname*: Applicants Group Number*: (This number is in the email invitation you were sent) 1. How long have you known the applicant and in what capacity? (e.g. Employer/Previous Group Leader/ Teacher/Priest) 2. Are you aware of any incident involving the applicant which could cause any doubts about his/her suitability to be closely associated with children or vulnerable adults? 3. Please comment on your knowledge of the applicant’s suitability and capability of co-operating and working with children, vulnerable adult and with other adults in a small team? 4. I recommend the person named above to be a helper in an HCPT Group.* Yes No 5. Any additional comments about the applicant.