Testimonial Request Form:

You are required to provide at least two testimonials. Please complete this form for each testimonial.
Thank you.

This form will send your referee an automatic email, requesting that they provide a reference/testimonial for you.
Should you wish to talk to them first, please do not forget to submit this information as soon as possible. Your application will not be progressed without this detail.
Thank you.

Your referees name, email address, and address will only be used to contact them in relation to your application.

All fields are mandatory, unless otherwise stated.

Please enter your full name(Required)

First Name Last Name

Email address(Required)

Your email address will be used to contact your referee with your request for a reference/testimonial and you in relation to your application, and if successful, contract with the IRCM CIC.

Enter Email Confirm Email

Position applied for(Required)

Additional Information (optional)

Please note this information will not be included in the email sent to your referee.

Referee details

Your referee details will only be used to contact your referee with your request for a reference/testimonial.

Referee Name(Required)

First Last

Referee Email(Required)

Enter Email Confirm Email

Referee Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Referee relationship to you(Required)

Referee relationship - Other details(Required)

Personal message to the Referee(Required)

Please use this space to send a personal message to your referee.

I declare that ...(Required)

By submitting this form, I declare that I have permission to provide the IRCM CIC with these referee details.

I declare that ...(Required)

By submitting this form, I declare that, to the best of my knowledge, the information provided on this form is correct.

I confirm that ...(Required)

I confirm that I give authority for the information to be stored in the HR contact database for the purpose(s) as defined within this application process.

I agree that ...(Required)

I agree that all information will be treated as part of my Contract should I be successful.

Currently, all information provided by and correspondence with the IRCM CIC is in English.