Note to the Candidate:

Give this form to a referee who can help us with his assessment of your academic potential for Ph.D.
The referee may be requested to mail it directly to us after filling it.
Name of the Applicant ____________________________________________________________________________
DepartmentProgramme to which admission is sought
Note for the Referee
To help us in the appraisal of the candidate!s case for admission to a graduate programme at ""T #anpur$ you are requested to fill in
the following information to the best of your %nowledge. This information will be treated as strictly confidential.
1. " have %nown the applicant for years.
&y %nowledge of this student is based on'
(aving himher in one or more courses
#nowing himher personally
)upervision of hisher thesispro*ect
"nquiry and discussion with my colleagues
+. Performance in my ,ourses'
Course Title No. of Students Grade Remarks
-. The candidate ran%s appro.imately _____________ in a class of about _______________ students.
4. &y rating of the candidate in following traits'
Excellent Good Poor Unable to jude
Analytical Ability
/.perimental )%ills
&otivation
0ritten and 1ral /.pression
2esponsibility
Teaching Ability
3. Any other remar%s ____________________________________________________________________________
4. To summari5e$ " would say that the applicant'
is li%ely to become a brilliant scholar
is li%ely to do very well in the Ph. D. programme
is li%ely to perform satisfactory
is not a good prospect
6. &y recommendation'
" recommend himher without any reservations
" recommend himher
" do not recommend himher
Name of the 2eferee _______________________________ )ignature ______________________________
DesignationPosition _______________________________ Date _______________________________