Last updated November 2019 Please check the ACECQA website to ensure that you are using the current version
© 2019 Australian Children’s Education and Care Quality Authority
Skills Assessment
Employer Reference Template
Employer Reference Template
This form must be completed by your employer. Use a separate form for each period of employment you wish to claim.
1. Business details
Business name
Business address
State or province Postcode Country
Phone number
Business email
Business website
2. Applicant’s Employment
Position title
Is the applicant currently employed here? Yes No
Date commenced Date completed
(Day/Month/Year) (Day/Month/Year)
Employment Full time Part time Casual / Voluntary
Normal working hours Salary
per week (Per annum)
3. Responsibilities of the role
Briefly describe the standard responsibilities of the position:
/ /
/ /
( )
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Skills Assessment
Employer Reference Template
Describe the tasks and duties the applicant was required to perform in their employment capacity, and
provide key examples of when you saw the required competencies of the role being demonstrated:
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Skills Assessment
Employer Reference Template
4. Employer Declaration
Please tick each clause below and sign the declaration
I, (the employer) declare that:
The applicant (stated below) was employed for the period specified and in the role identified.
I have witnessed or directly supervised the applicant conducting the specified tasks and duties in their
capacity of employment.
I understand that providing false or misleading information is an offence and all the information I
have provided is true and correct.
Day Month Year
Employer Date
Employer position / role
Applicant name
/ /