Reference Request Form

Applicant’s Name Sonia Langhani

Position Applied for with PSS Worker-MHPSS

IMC:

About the applicant…

Position(s) held:
Behaviour Therapist
(Please provide exact job title)

-Deals children with learning disability, autistic and children with

ADHD.
Purpose of the role/ summary
of duties and responsbilities -Counseling children to deal with their day to day life problems.
-Taking one to one sessions of these children.

Spectific Dates of Employment:

From: June 2022 To: September 2022
(Please provide exact dates)

Reason for leaving

employment with you:
-Timings Issues which were from 8:30am to 5:45pm
(If dismissal please provide
details)

Would your organisation re-

Yes No
employ the applicant?

If no, please give your reasons:      -

During employment with you, was the applicant subject of a Disciplinary or capability procedure?
Yes

No
If yes, please supply full details and outcome
-

1|Page
 Reference Request Form

Were the applicant’s behaviour patterns acceptable and did they conform to high standards
of professional code of conduct of your organisation?
Yes

Were there any professional causes for concern during the applicant’s employment?

No

Please state briefly what you believe to be the applicant greatest strengths and weaknesses:
Strengths:
 Adaptable
 Flexible
 Resilient
 Keen to Learn
Weaknesses:
 Involved in work so much that sometimes cannot pay attention to deadlines

Any other comments we should consider that you might think we may find helpful in making a
hiring decision with respect to the above mentioned candidate?

She works with honesty and will prove as a great asset to your organization.

 Safeguarding issues…

International Medical Corps is committed to the welfare and protection of our beneficiaries and
staff from abuse and harm.  As such, do you have any knowledge or any reason to believe that
this applicant has previously displayed any forms of abuse or would have trouble complying
with International Medical Corps' commitment concerning protection of beneficiaries and
Staff?

No

 About the referee…

Name: Ms. Anum Rizwan

2|Page
 Reference Request Form

Employing Organisation: Institute of Behavioral Psychology

Job title in Organisation: Senior Employee

Official contact details

0348-2977589
Telephone No#:
anumrizwanfazal@gmail.com
E-mail Address:

Relationship to Applicant:
(In what capacity are you Length of
Professional Collegue 1 year
providing this reference?) relationship:

Thank you for your prompt response in this matter.

3|Page